open access

Vol 19, No 3 (2012)
Case Reports
Published online: 2012-05-28
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Intramural hemotoma presenting as acute coronary syndrome: The importance of intravascular ultrasound

Yogesh Raja, Jasper Trevelyan, Sagar N. Doshi
Cardiol J 2012;19(3):323-325.

open access

Vol 19, No 3 (2012)
Case Reports
Published online: 2012-05-28

Abstract

Intramural hematoma in major coronary epicardial vessels is a rare cause of chest pain. Afflicted individuals may present with acute coronary syndrome (ACS) or even sudden cardiac death. Spontaneous, isolated intramural hematoma may occur in the absence of associated intimal dissection. In this situation, lesions may be angiographically indistinguishable from ruptured atherosclerotic plaque. Intravascular ultrasound is important in the accurate diagnosis of isolated intramural hematoma. Although coronary stenting may be required in the presence of ongoing ischemia, intramural hematoma may be successfully managed medically. We describe the case of a middle-aged woman who presented with ACS due to an intramural hematoma and discuss the diagnosis and management of this rare illness.

Abstract

Intramural hematoma in major coronary epicardial vessels is a rare cause of chest pain. Afflicted individuals may present with acute coronary syndrome (ACS) or even sudden cardiac death. Spontaneous, isolated intramural hematoma may occur in the absence of associated intimal dissection. In this situation, lesions may be angiographically indistinguishable from ruptured atherosclerotic plaque. Intravascular ultrasound is important in the accurate diagnosis of isolated intramural hematoma. Although coronary stenting may be required in the presence of ongoing ischemia, intramural hematoma may be successfully managed medically. We describe the case of a middle-aged woman who presented with ACS due to an intramural hematoma and discuss the diagnosis and management of this rare illness.
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Keywords

intracoronary ultrasound; intramural hematoma; coronary stenting

About this article
Title

Intramural hemotoma presenting as acute coronary syndrome: The importance of intravascular ultrasound

Journal

Cardiology Journal

Issue

Vol 19, No 3 (2012)

Pages

323-325

Published online

2012-05-28

Bibliographic record

Cardiol J 2012;19(3):323-325.

Keywords

intracoronary ultrasound
intramural hematoma
coronary stenting

Authors

Yogesh Raja
Jasper Trevelyan
Sagar N. Doshi

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