Spontaneous retraction of an intramyocardial dissecting hemorrhage and multiple left ventricular thrombus formations in subacute myocardial infarction and antiphospholipid syndrome: a case report with long-term follow-up.
This report describes a 68-year-old patient with a subacute myocardial infarction and antiphosholipid syndrome. He developed an intramyocardial dissecting hemorrhage involving the left ventricular apex and multiple left ventricular thrombus formations, documented by contrast echocardiography and magnetic resonance imaging. By use of transthoracic echocardiography, spontaneous retraction of the dissecting hemorrhage could be detected. Severe coronary 3-vessel disease was successfully treated by coronary artery bypass grafting. During follow-up of 16 months, the dissecting hematoma could not been detected. Under initiation of anticoagulant treatment with Coumadin, the patient was in stable clinical condition and improved in New York Heart Association class from III to II. The pathophysiology, diagnosis, and management of this potentially highly lethal complication is reviewed.
Bahlmann
Edda
E
Department of Cardiology, St Georg Hospital, Hamburg, Germany.
Schneider
Carsten
C
Vitali Serdoz
Laura
L
Hoffmann-Riem
Martin
M
Broemel
Thomas
T
Kuck
Karl-Heinz
KH
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D016736:Antiphospholipid Syndrome / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D012075:Remission, Spontaneous; D013927:Thrombosis / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*