Demonstrates the utility of multimodality imaging in diagnosing a rare dissecting intramyocardial hematoma post-myocardial infarction.
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May prompt multimodality imaging for atypical post-MI presentations; single case leaves open incidence, management, and outcomes data.
F ive days after the onset of substernal chest pain, a 60-year-old man with a history of hypertension, smoking (60 pack-years), severe bullous emphysema, and epilepsy presented with acutely worsening chest pain. Pharmacological management for non-ST-segment elevation myocardial infarction was initiated based on 12-lead ECG findings of subtle anterolateral ST segment changes (V2-V5) and a troponin I level of 6.36 ng/mL (normal 0.04 ng/mL).
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Wilson et al. (2012) studied this question.
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