Intramyocardial Dissecting Hematoma as a Rare Complication of Myocardial Infarction: The Importance of Echocardiographic Diagnosis: case report.

Authors

  • Alexandre José Esteche Ruíz Departamento de Cardiología. Hospital Central del IPS. Asunción. Paraguay. https://orcid.org/0009-0008-3745-4870
  • Luis Benítez Sienra Departamento de Cardiología. Hospital Central del IPS. Asunción. Paraguay. https://orcid.org/0009-0005-7556-3208
  • Elva Amarilla Ortiz Departamento de Cardiología. Hospital Central del IPS. Asunción. Paraguay. https://orcid.org/0009-0008-2416-5391
  • Alejandra Solaeche Schussmüller Departamento de Cardiología. Hospital Central del IPS. Asunción. Paraguay.
  • Guillermo Aldama Negrete Departamento de Cardiología. Hospital Central del IPS. Asunción. Paraguay. https://orcid.org/0000-0003-2461-8801

DOI:

https://doi.org/10.37615/retic.v9n2a5

Keywords:

intramyocardial hematoma, myocardial infarction, echocardiography, heart failure, case reports

Abstract

Intramyocardial dissecting hematoma is a rare myocardial infarction complication, characterized by neo-cavities due to intramyocardial vessel rupture. We report a case of a 50-year-old patient with a history of non-revascularized infarction who presented with decompensated heart failure. Echocardiography revealed severe ventricular dysfunction and suspected intramyocardial dissection. Conservative management was chosen with echocardiographic follow-up. Echocardiography plays a crucial role in diagnosis and monitoring, especially when cardiac MRI is unavailable. In selected cases, conservative treatment may lead to spontaneous resolution.

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References

Agarwal G, Kumar V, Srinivas KH, et al. Intramyocardial dissecting hematoma of the left ventricle. JACC Case Rep. 2020;3(1):94-98. doi: https://doi.org/10.1016/j.jaccas.2020.07.038

Dias V, Cabral S, Gomes C, et al. Intramyocardial dissecting hematoma: a rare complication of acute myocardial infarction. Eur Heart J Cardiovasc Imaging. 2009;10(4):585-587. doi: https://doi.org/10.1093/ejechocard/jep027

Vargas-Barrón J, Roldán FJ, Romero-Cárdenas A, et al. Dissecting intramyocardial hematoma: clinical presentation, pathophysiology, outcomes, and delineation by echocardiography. Echocardiography. 2009;26:254-261. doi:https://doi.org/10.1111/j.1540-8175.2008.00804.x

Sakrana AA, Alzubaidi SAA, Shahat AM, et al. Echocardiographic and cardiovascular magnetic resonance findings of a large thrombosed intramyocardial dissecting hematoma: a case report and brief literature review. BJR Case Rep. 2020;6:20200028. doi: https://doi.org/10.1259/bjrcr.20200028

Vargas-Barrón J, Romero-Cárdenas A, Roldán FJ, et al. Long-term follow-up of intramyocardial dissecting hematomas complicating acute myocardial infarction. J Am Soc Echocardiogr. 2005;18(12):1422.e1-1422.e6. doi: https://doi.org/10.1016/j.echo.2005.03.010

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Published

2026-08-24

How to Cite

1.
Esteche Ruíz AJ, Benítez Sienra L, Amarilla Ortiz E, Solaeche Schussmüller A, Aldama Negrete G. Intramyocardial Dissecting Hematoma as a Rare Complication of Myocardial Infarction: The Importance of Echocardiographic Diagnosis: case report. Rev Ecocardiogr Pract Otras Tec Imag Card (RETIC) [Internet]. 2026 Aug. 24 [cited 2026 Aug. 26];9(2):23-7. Available from: https://imagenretic.org/RevEcocarPract/article/view/733

Issue

Vol. 9 No. 2 (2026): Revista de Ecocardiografía Práctica y Otras Técnicas de Imagen Cardíaca

Section

CLINICAL CASES

License

Copyright (c) 2026 Alexandre José Esteche Ruíz, Luis Benítez Sienra, Elva Amarilla Ortiz, Alejandra Solaeche Schussmüller, Guillermo Aldama Negrete

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

RETIC is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license https://creativecommons.org/licenses/by-nc-nd/4.0 which allows sharing, copying and redistribution of the material in any medium or format, under the following terms:

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