ABSTRACT
The Covid-19 pandemia has many other undesirable consequences apart of virus infection. Less people is hospitalized due to acute coronary syndrome and the delay to seek medical attention has increased. Patients with ST segment elevation myocardial infarction arrive at the hospital too late to be timely treated and we have recently seen mechanical complications that were more frequent in the past decades before the use of reperfusion strategies. In this report we describe the presentation, evolution and detailed imaging evaluation of two patients with unusual presentations of cardiac rupture: left ventricular pseudoaneurysm and left ventricular intramyocardial dissecting hematoma.
Subject(s)
COVID-19/epidemiology , Echocardiography/methods , Heart Rupture, Post-Infarction/etiology , Heart Ventricles/diagnostic imaging , Pandemics , ST Elevation Myocardial Infarction/epidemiology , Aged , Comorbidity , Female , Heart Rupture, Post-Infarction/diagnosis , Heart Rupture, Post-Infarction/epidemiology , Humans , Male , Middle AgedABSTRACT
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. CLINICAL CASE: 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.
