Spontaneous intramyocardial hematoma presenting as a rapidly expanding mass followed by echocardiography.
A50-year-old man with an intramyocardial mass was referred to us. He had undergone resection of both a coronary arterial aneurysm of unknown origin and a postinfarction left ventricular (LV) aneurysm 5 years before. Peak creatine kinase was slightly over the upper normal range, and an electrocardiogram revealed neither a new Q-wave nor an additional ST-segment change. Repeated two-dimensional echocardiography indicated rapid expansion of a heterogeneous mass in the posterior wall of the LV. The mass was intraoperatively diagnosed as intramyocardial hematoma without connection to the LV cavity. Via posterolateral thoracotomy with partial cardiopulmonary bypass, the outer layer of the hematoma was completely resected, and xenopericardium was applied with a continuous suture to cover the space which the hematoma had occupied. The patient made an uneventful recovery.
First Department of Surgery, Gifu University School of Medicine, 40 Tsukasa, Gifu 500-8705, Japan. h-takagi@cc.gifu-u.ac.jp
Hisato
H
Takagi
Yoshio
Y
Mori
Hisashi
H
Iwata
Masaki
M
Kimura
Masazumi
M
Arai
Kazuhiko
K
Nishigaki
Hisayoshi
H
Fujiwara
Hajime
H
Hirose
D009202:Cardiomyopathies / Q000145:classification / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D004452:Echocardiography; D006406:Hematoma / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome