A Case Report of Intramyocardial Dissecting Hematoma Similar to Left Ventricular Mural Thrombus

Background: Intramyocardial Dissecting Hematoma (IDH) is one of the serious and rare complications of acute myocardial infarction (AMI). It is a manifestation of subacute cardiac rupture and has a high mortality rate. With the development of imaging technology, especially echocardiography, this complication has been gradually recognized. Case Presentation: The patient had intermittent chest and back pain without obvious inducement and did not seek medical treatment in time. One month later, the patient came to the hospital for treatment due to the aggravation of the condition. Transthoracic echocardiography (TTE) in the other hospital showed segmental wall motion abnormality and hypoechoic mass in the left ventricular apex, which was considered thrombosis. In our hospital, the diagnosis by Transthoracic echocardiography combined with left ventricular opacification (LVO) was: segmental wall motion abnormality, left ventricular apex hypoecho mass, intramyocardial dissecting with hematoma formation were considered. Later, the diagnosis of Intramyocardial dissecting with hematoma formation was confirmed by cardiac magnetic resonance (CMR) examination in a superior hospital. Conclusion: In this case report, by analyzing the ultrasound imaging manifestations of left ventricular intramyocardial dissecting hematoma after myocardial infarction and its differential diagnosis with left ventricular mural thrombosis, we deepened the understanding of this rare complication and provided a reliable basis for clinical treatment decisions.