title: Subepicardial hematoma after percutaneous coronary intervention.
abstract: BACKGROUND
  Coronary artery perforation associated to cardiac tamponade is an uncommon life-threatening complication of percutaneous coronary intervention, and the occurrence of subepicardial or intramyocardial hematoma without hemopericardium is even rarer.
  
  
  METHODS
  We describe the case of a 72 year-old woman with a subepicardial hematoma after percutaneous coronary intervention, who required urgent left internal mammary artery graft to anterior descending artery surgery.
  
  
  CONCLUSIONS
  Subepicardial or intramyocardial hematoma must be considered when a coronary perforation is suspected in absence of hemopericardium. Transthoracic echocardiogram or computed tomography may be used to decide a conservative or invasive approach.
authors.affiliation: IMA Clinic, Adrogué, Buenos Aires, Argentina. Electronic address: raborracci@gmail.com.
authors.forename: Raúl Alberto
authors.initials: RA
authors.lastname: Borracci
authors.affiliation: IMA Clinic, Adrogué, Buenos Aires, Argentina.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ayala
authors.affiliation: IMA Clinic, Adrogué, Buenos Aires, Argentina.
authors.forename: Paola
authors.initials: P
authors.lastname: Renes
authors.affiliation: IMA Clinic, Adrogué, Buenos Aires, Argentina.
authors.forename: Norberto Gustavo
authors.initials: NG
authors.lastname: Allende
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D004630:Emergencies; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D010496:Pericardium; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D012086:Reoperation; D012501:Saphenous Vein / Q000637:transplantation; D014057:Tomography, X-Ray Computed
keywords: Cirugía coronaria; Coronary artery perforation; Coronary surgery; Epicardio; Hematoma intramiocárdico; Intervención coronaria percutánea; Intramyocardial hematoma; Percutaneous coronary intervention; Perforación de arteria coronaria; Subepicardial