Endocardial dissection and multi-organ failure in a patient with ischemic cardiomyopathy and severe frostbite

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Endocardial dissection and multi-organ failure (n=1). Intervention: Intensive care (vasopressors, antibiotics, hemodialysis). Primary outcome: Clinical outcome.

Jakub Powroźnik; Anna Fojt; Magdalena Warych; Martyna Winiecka; Monika Budnik; Robert Kowalik; Marcin Grabowski

doi:10.33963/v.phj.113218

June 19, 2026Kardiologia PolskaOpen Access

Endocardial dissection and multi-organ failure in a patient with ischemic cardiomyopathy and severe frostbite

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Key result

Spontaneous endocardial dissection causes rapid death in a patient with ischemic cardiomyopathy and severe frostbite.

n=1

Key Points

To describe a rare case of spontaneous endocardial dissection and fatal multi-organ failure in a patient with pre-existing ischemic cardiomyopathy and severe frostbite.
Clinical evaluation of a 61-year-old male presenting with NYHA class IV symptoms, mixed cardiogenic-septic shock, and grade IV frostbite.
Diagnostic workup using laboratory assays, electrocardiography, and contrast-enhanced transthoracic echocardiography (TTE).
Bedside TTE revealed a severely reduced left ventricular ejection fraction of 10%–15%, left ventricular end-diastolic diameter of 8.1 cm, and an endocardial flap with subendocardial hematoma along the anterior wall and septum.
Laboratory testing demonstrated acute multi-organ failure and systemic inflammation, including creatinine of 4.65 mg/dl, lactate of 8.8 mmol/l, C-reactive protein of 341.4 mg/l, and procalcitonin of 27.2 ng/ml.
The patient developed refractory anuric acute kidney injury and died on hospital day two following two cardiac arrests despite vasopressor support and hemodialysis.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

1 61-year-old male with a history of acute myocardial infarction, ischemic cardiomyopathy, and chronic heart failure presenting with NYHA class IV symptoms, non-specific chest pain, and IV-degree frostbite.

Spontaneous endocardial dissection is a rare, potentially fatal complication in patients with severely remodeled myocardium that can be diagnosed using bedside transthoracic echocardiography.

Limitations

Single case report
Lack of an established cause for the complication
Profound hemodynamic instability precluded surgical intervention

Implication

Endocardial dissection warrants consideration in frostbite with ischemic cardiomyopathy; this Level 5 case leaves open prevalence and causality.

Abstract

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Discussion

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Cite This Study

Powroźnik et al. (2026) conducted a case report in Endocardial dissection and multi-organ failure (n=1). Intensive care (vasopressors, antibiotics, hemodialysis) was evaluated on Clinical outcome. A 61-year-old male with ischemic cardiomyopathy and severe frostbite developed spontaneous endocardial dissection and multi-organ failure, leading to death on the second hospital day.

synapsesocial.com/papers/6a3c233cd15afadd906f9e1e https://doi.org/10.33963/v.phj.113218

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Endocardial dissection and multi-organ failure in a patient with ischemic cardiomyopathy and severe frostbite

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Endocardial dissection and multi-organ failure in a patient with ischemic cardiomyopathy and severe frostbite

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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