J Cardiovasc Ultrasound.  2009 Sep;17(3):99-101. 10.4250/jcu.2009.17.3.99.

Right Ventricular Wall Hematoma Secondary to Percutaneous Coronary Intervention

• Lee YW
• Chun KJ
• Park YH
• Kim JS
• Kim J
• Kim JH
• Lee SG
• Lee DI
• Kim JH

• KMID: 1473734
• DOI: http://doi.org/10.4250/jcu.2009.17.3.99

Abstract

Intramyocardial hematoma is known to be associated with myocardial infarction, chest trauma, coronary artery bypass operation, and complication of percutaneous coronary intervention (PCI). We describe here a rare case of 50-year-old man with a huge right ventricular (RV) wall hematoma which was newly developed two hours after PCI. The patient was treated conservatively with a successful outcome. We discuss plausible mechanisms for the development of RV wall hematoma and treatment options for the case.

Keyword

Hematoma; Complication; Right ventricle; Percutaneous coronary intervention

MeSH Terms

Coronary Artery Bypass
Heart Ventricles
Hematoma
Humans
Middle Aged
Myocardial Infarction
Percutaneous Coronary Intervention
Thorax

Figure

• 

  Fig. 1 Final angiogram after stenting shows acceptable results at posterior descending artery and posterolateral branch of right coronary artery (A). Emergent coronary angiogram reveals a large amount of frank streaming of contrast material (arrows) in RV wall (B). RV: right ventricular.

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  Fig. 2 Transthoracic echocardiogram from apical 4-chamber view shows a large right ventricular wall mass that almost completely obliterates right ventricular chamber. A small pericardial effusion is also present. H: hematoma, LA: left atrium, LV: left ventricle, RA: right atrium.

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  Fig. 3 Follow-up coronary angiogram shows a direct communication between hematoma and right ventricular cavity through fistula (arrow).

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  Fig. 4 A final echocardiogram at eight weeks after percutaneous coronary intervention shows a complete resolution of the hematoma. LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle.

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