Large Coronary Intramural Hematoma Presenting as Acute Coronay Syndrome


Isolated spontaneous coronary intramural hematoma is characterized by a hemorrhage limited to the media–adventitial layers, causing subsequent hematoma formation without visible intimal flaps. Spontaneous isolated intramural hematoma may occur in the absence of associated intimal dissection. It is an infrequent and serious coronary vessel wall pathology with poorly understood underlying pathogenic mechanisms. Affected individuals may present with a broad spectrum of symptoms ranging from acute coronary syndromes (ACS) to cardiogenic shock or even sudden cardiac death. The disease entity causes challenges in terms of both diagnostic and treatment strategy. We report a case of intramural coronary hematoma in a patient presenting with non ST-segment elevation myocardial infarction.

Spontaneous coronary intramural hematoma in major epicardial coronary vessels is a rare cause of chest pain. The hematoma formation is limited to the media–adventitial layers, and no flaps are visible when assessed with tomographic techniques. This serious condition usually presents as acute coronary syndrome (ACS) but symptoms may range from chest pain to cardiogenic shock or sudden death,1,2 depending on hematoma location, number of affected vessels, lumen compromise and restriction of coronary blood flow. It is more frequent in young women, particularly in the peri and post- partum period and with oral contraceptive use, and in young and middle-aged patients without obvious cardiovascular risk factors. Management strategies may range from conservative medical treatment to percutaneous or surgical interventions depending upon the anatomy, extent of the hematoma and the clinical circumstances. We report a case of intramural coronary hematoma in a patient presenting with non ST- segment elevation myocardial infarction.

https://www.stephypublishers.com/sojccts/pdf/SOJCCTS.MS.ID.000507.pdf


Comments

Post a Comment

Popular posts from this blog

Image
 Sustainable Development: Reality Or Myth? Since the United Nations Environment Conference in Stockholm (1972), the concept of sustainable development has steadily made its way among individual scientists and international organizations. The apotheosis of this development was the adoption by the United Nations in 2015 of the 17 Sustainable Development Goals. However, many scientists and politicians were skeptical about the concept of sustainable development, since the results of implementing sustainable development in different countries were far from expected. Many decisions taken at the level of the UN and other international organizations turned out to be unfulfilled. In my opinion, as well as some other Russian scientists, the concept of sustainable development is an unrealistic project, it is a myth, although it is very positive and humane. Sustainable development goals can be achieved only by the most economically developed countries entering the era of post-industrialism. In...
Read more
Image
 Lateral Rock Characteristic Evidence of Hydrocarbon Restoration from Post-Stack Impedance Inversion: A Case Study of ZED-field Offshore Niger Delta Lateral predictions of rock properties that are descriptive of a reservoir have been studied using a model-established seismic inversion approach that was used to convert input seismic data into an acoustic impedance structure to optimize hydrocarbon restoration in the field. This was actualized by integrating wireline logs and 3D post stack seismic data procured from ZED-Field offshore Niger Delta. The inversion system employed in this study comprises of forward modelling of reflection coefficients starting with a low-frequency impedance model induced from well logs and convolution of the reflection coefficients with the source wavelet extracted from the seismic input. P-impedance analysis at reservoir C5000 delineated from the control well gave a near perfect correlation of 0.998109 (≈ 99.8 %) between the original P-impedance log, in...
Read more
Image
 How to Treat Cancer Properly Cancer is one of the deadliest diseases in the world, chemotherapy is effective under some conditions, but has too heavy side effects, and it is not effective to a considerable proportion of cases while the side effects are often life-threatening, drugs (not unhealthy addictive drugs mentioned in reference four, the drug in reference four only mean those makes people addictive but does no good to health, destroying health quickly) are not always available to improve the condition. However, sport is a potential treatment that is effective to cancer before the cancer is disseminated, this gets little attention but is true both in theory and practice. The physical activities that have moderate intensity and duration should have devastating effects on cancer cells, they make the body hot and reduce the nutritional resources that cancer cells can get, also renew the proteins in the body and improve one’s mood, cancer cells are hard to live when one is activ...
Read more