Cardiac Computed Tomography to Identify and Guide Therapy of Intramural Hemorrhage in High-Risk Coronary Anatomy

Kumar Jatti; Pal Maurovich-Horvat; Jonathan Hasleton; Muezz Uddin; Balazs Ruzsics

doi:10.1016/j.jaccas.2020.11.014

Cardiac Computed Tomography to Identify and Guide Therapy of Intramural Hemorrhage in High-Risk Coronary Anatomy

JACC Case Rep. 2021 Jan 20;3(1):120-124. doi: 10.1016/j.jaccas.2020.11.014. eCollection 2021 Jan.

Authors

Kumar Jatti¹, Pal Maurovich-Horvat², Jonathan Hasleton^{1

3}, Muezz Uddin³, Balazs Ruzsics¹

Affiliations

¹ Department of Cardiology, Royal Liverpool University Hospitals National Health Service Foundation Trust Royal Liverpool University Hospital, Liverpool, United Kingdom.
² Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
³ Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.

Abstract

Coronary intramural hematoma can present with acute coronary syndrome. We present a 39-year-old man with post-assault stress-induced left main intramural hematoma. We used computed tomography coronary angiogram with lesion characterization and suspected the diagnosis of intramural hematoma despite its limited spatial resolution; computed tomography was used for follow-up imaging and proper monitoring of therapeutic measures. (Level of Difficulty: Advanced.).

Keywords: ACS, acute coronary syndrome; CT, computed tomography; CTCA, CT coronary angiogram; IMH, intramural hemorrhage; IVUS, intravascular ultrasound; LM, left main; MDT, multidisciplinary team meeting; PCI, percutaneous coronary intervention; SCAD, spontaneous coronary artery dissection; acute coronary syndrome; computed tomography coronary angiography; coronary intramural hematoma.

Publication types

Case Reports