Abstract
Intramyocardial dissecting hematoma (IDH) is a rare form of cardiac rupture that can occur as a complication following acute myocardial infarction (MI) or during the remodeling process. It is usually caused by a hemorrhagic dissection through the myocardium.1, 2 It consists of blood infiltration into and through the myocardial wall, which maintains endocardial and epicardial integrity. Formation of IDH may result from rupture of intramyocardial vessels into the interstitial space, decreased tensile strength of the infarcted area, and acute increase of coronary capillary perfusion pressure.3, 4 Before the advent of noninvasive imaging techniques, the diagnosis of IDH was made only by necropsy. It can develop in the left ventricular (LV) free wall, the right ventricle, or the interventricular septum.5 We describe three cases, focusing on the utility of echocardiography and the use of other noninvasive imaging modalities. All of our patients were treated conservatively.
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