Chest Pain and the Dynamic Evolution of Spontaneous Coronary Artery Hematoma

Marco Franzino; Francesco Costa; Tommaso De Ferrari; Giampiero Vizzari; Giuseppe Andò; Fabrizio Ceresa; Francesco Patanè; Gianluca Di Bella; Antonio Micari

doi:10.1016/j.jaccas.2022.09.031

Chest Pain and the Dynamic Evolution of Spontaneous Coronary Artery Hematoma

JACC Case Rep. 2022 Nov 4:6:101673. doi: 10.1016/j.jaccas.2022.09.031. eCollection 2023 Jan 18.

Authors

Marco Franzino¹, Francesco Costa¹, Tommaso De Ferrari¹, Giampiero Vizzari¹, Giuseppe Andò², Fabrizio Ceresa³, Francesco Patanè³, Gianluca Di Bella², Antonio Micari¹

Affiliations

¹ Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, AOU Policlinic "G. Martino," Messina, Italy.
² Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinic "G. Martino", Messina, Italy.
³ Division of Cardiac Surgery, Department of Cardio-Thoraco-Vascular Surgery, Papardo Hospital, Messina, Italy.

Abstract

Spontaneous coronary intramural hematoma (SCIH) is a rare but underdiagnosed condition, with dynamic evolution. We present a patient with acute chest pain and normal coronary angiogram undergoing work-up for myocardial infarction with nonobstructive coronary arteries. Cardiac magnetic resonance revealed an ischemic pattern, and subsequent angiography revealed coronary occlusion by SCIH. (Level of Difficulty: Intermediate.).

Keywords: CMR, cardiac magnetic resonance; CT, computed tomography; IVUS; IVUS, intravascular ultrasound; MI, myocardial infarction; MINOCA; MINOCA, myocardial infarction with nonobstructive coronary arteries; SCAD; SCAD, spontaneous coronary artery disease; SCIH, spontaneous coronary intramural hematoma; acute coronary syndrome; cardiac magnetic resonance; spontaneous coronary intramural hematoma.

Publication types

Case Reports