Pericardial Hematoma After Primary Angioplasty Complicated by Coronary Rupture
Coronary artery rupture is a rare complication of percutaneous transluminal coronary angioplasty. Most patients undergo emergency bypass surgery, so the natural course of these events remains unclear. The following images demonstrate a pericardial hematoma, caused by perforation of the right coronary artery. A 59-year-old man underwent primary angioplasty during inferior myocardial infarction. Perforation of the right coronary artery was noted, with extravasation of contrast (Figure⇓), and was treated conservatively. Nine months later, the patient was referred for evaluation of a pericardial mass. MRI images and transthoracic echocardiogram demonstrate a noncommunicating intrapericardial hematoma. The patient remains symptom free.
Dr Zellner was partially funded by a grant from the Philips Corporation.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
- Copyright © 1998 by American Heart Association