RESUMO
Right ventricular (RV) intramyocardial hematoma is a potentially life-threatening condition that can complicate percutaneous coronary intervention (PCI). Natural course of RV hematoma and long-term recovery of the affected myocardium have not been described. We present a case of a 70-year-old male with large RV hematoma caused by distal guidewire perforation during PCI of the right coronary artery. Baseline multimodality imaging, serial echocardiography, and long-term follow-up using cardiac magnetic resonance (CMR) imaging were used to investigate the natural course of this rare condition. Despite its massive initial appearance, the hematoma was successfully managed conservatively. Serial echocardiographic examination showed slow gradual resorption of the hematoma. Follow-up CMR performed at 12 months was strikingly normal, showing no late gadolinium enhancement of the RV myocardium indicating lack of significant fibrotic scarring at the site of hematoma resorption.
