Document Detail

Acute myocardial infarction caused by spontaneous coronary intramural hematoma.
MedLine Citation:
PMID:  23220989     Owner:  NLM     Status:  In-Data-Review    
A 49-year-old male presented to our emergency department with sudden anterior chest pain. His electrocardiogram revealed ST-segment elevations in leads II, III and aVF. An inferior acute myocardial infarction was suspected. Emergent coronary angiography (CAG) showed there was a long lesion in the right coronary artery (RCA), which continued from the proximal to the distal part of RCA with 50% stenosis and narrowed further to 99% stenosis at the distal end. Intravascular ultrasound (IVUS) examination demonstrated a diffuse intramural hematoma raging from the proximal to the distal part of the RCA. No visualization of the intimal flap was identified by IVUS, indicating coronary artery dissection as a pathogenesis of this hematoma formation. After intracoronary injection of isosorbide dinitrate, the 99% stenosis regressed to 50% spontaneously. Neither balloon angioplasty nor stenting was performed. He was discharged home free from symptoms 9 days after the procedure. Thirty-day follow-up CAG revealed an almost normal finding of the RCA and IVUS delineated a complete restoration of the intramural hematoma.
Ryutaro Ikegami; Keiichi Tsuchida; Hirotaka Oda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  24     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  692-3     Citation Subset:  IM    
Department of Cardiology, Niigata City General Hospital,Shumoku 463-7, Chuo-ku, Niigata 950-1197, Japan.
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