Post-myocardial infarction left ventricular intramyocardial dissecting hematoma

نویسندگان

چکیده

Úvod: IntramyokardiĂĄlnĂ­ disekujĂ­cĂ­ hematom (IDH) je dutina ve stěně srdce vyplněnĂĄ krvĂ­, kterĂĄ vznikĂĄ oslabenĂ­m stěny nekrĂłzou po infarktu myokardu. IDH se mĹŻĹže vytvořit levĂŠ komory, pravĂŠ komory nebo interventrikulĂĄrnĂ­ho septa. Popis případu: Kazuistika popisuje pacienta s jako vzĂĄcnou komplikaci Pacient byl hospitalizovĂĄn pro trvajĂ­cĂ­ obtěžujĂ­cĂ­ kaĹĄel tři měsĂ­ce prodělĂĄnĂ­ myokardu řeĹĄenĂŠm implantacĂ­ stentu. Dle echokardiografie bylo podezřenĂ­ na krytou rupturu volnĂŠ laterĂĄlnĂ­ obrazem pseudoaneu- rysmatu, kterou rozhodnuto o operačnĂ­m řeĹĄenĂ­. Při operaci nĂĄlez ploĹĄnĂŠ dutiny komunikujĂ­cĂ­ otvorem levou komorou. VnitřnĂ­ i vnějĹĄĂ­ stěna obsahovala srdečnĂ­ svalovinu, a tak byla diagnostikovĂĄna IDH. Otvor byly uzavřeny stehy přes meshovĂŠ podloĹžky suturou meshovĂ˝ prouĹžek. PooperačnĂ­ prĹŻběh obeĹĄel bez komplikacĂ­ pacient propuĹĄtěn osmĂ˝ den operaci. Diskuse: Diagnostika zaklĂĄdĂĄ anamnĂŠze nĂĄlezech echokardiografii. Mezi znĂĄmky echokardiografickĂŠho obrazu patří vytvořenĂ­ novĂŠ uvnitř echolucentnĂ­m středem. DiferenciĂĄlnĂ­ diagnostika zahrnuje aneurysma, pseudoaneurysma, trombus LK trabekuly komor. ZĂĄvěr: komplikace myokardu, třeba pomýťlet při diferenciĂĄlnĂ­ diagnostice nově vzniklĂŠ ultrazvukovĂŠm vyĹĄetřenĂ­. KonzervativnĂ­ řeĹĄenĂ­ moĹžnĂŠ u malĂ˝ch rozměrĹŻ, kterĂ˝ch nedochĂĄzĂ­ k progresi. U hemodynamickĂŠ nestability velkĂ˝ch progredujĂ­cĂ­ch namĂ­stě chirurgickĂŠ © 2023, ČKS.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Rapid retraction of a post-infarction intramyocardial dissecting hematoma.

A 60-year-old male with a recent anterior myocardial infarction (MI) was referred to our hospital for implantable cardioverter defibrillator (ICD) implantation. He was on the 42nd day of MI and clinically stable on admission. Electrocardiography showed right bundle branch block with QS pattern on anterior leads. Transthoracic echocardiographic examination revealed an ejection fraction of 25% wi...

متن کامل

[Conservative management of a post infarction intramyocardial dissecting hematoma].

Intramyocardial dissecting hematoma is an infrequent complication of subacute myocardial infarction. Pathological findings consist of a cavity filled with blood, the outer wall of which is the myocardium and pericardium and the inner wall, which faces the ventricular cavity, is part of the myocardium and endocardium. There is scarce information on the subject and the management of these patient...

متن کامل

Multimodality imaging of a dissecting intramyocardial hematoma extending into the left atrial wall following myocardial infarction.

Five days after the onset of substernal chest pain, a 60-year-old man with a history of hypertension, smoking (60 pack-years), severe bullous emphysema, and epilepsy presented with acutely worsening chest pain. Pharmacological management for non–ST-segment elevation myocardial infarction was initiated based on 12-lead ECG findings of subtle anterolateral ST segment changes (V2–V5) and a troponi...

متن کامل

Images in Cardiovascular Medicine Multimodality Imaging of a Dissecting Intramyocardial Hematoma Extending into the Left Atrial Wall Following Myocardial Infarction

Five days after the onset of substernal chest pain, a 60-year-old man with a history of hypertension, smoking (60 pack-years), severe bullous emphysema, and epilepsy presented with acutely worsening chest pain. Pharmacological management for non–ST-segment elevation myocardial infarction was initiated based on 12-lead ECG findings of subtle anterolateral ST segment changes (V2–V5) and a troponi...

متن کامل

Early Spontaneous Remission of Intramyocardial Dissecting Hematoma

Intramyocardial dissecting hematoma is a rare but potentially fatal complication of myocardial infarction. The decision to adopt a surgical or conservative strategy may depend on the clinical and hemodynamic stability of patients. Regardless, the precise and temporal assessment of the structure of hematoma is imperative. We herein report the first case of a patient with early spontaneous remiss...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

ژورنال

عنوان ژورنال: Cor et vasa

سال: 2023

ISSN: ['0010-8650', '1803-7712']

DOI: https://doi.org/10.33678/cor.2022.089