CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
This article is part of the Research TopicExploring New Frontiers in Heart Surgery: Case Studies 2025View all 23 articles
Surgical treatment of intramyocardial dissecting hematoma - a case report and literature review
Provisionally accepted
- 1Univerza v Ljubljani Medicinska fakulteta, Ljubljana, Slovenia
- 2Univerzitetni klinicni center Ljubljana Klinicni oddelek za kardiologijo, Ljubljana, Slovenia
- 3Univerzitetni klinicni center Ljubljana Klinicni oddelek za kirurgijo srca in ozilja, Ljubljana, Slovenia
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Intramyocardial dissecting hematoma (IDH) is a rare but potentially life-threatening complication, most commonly linked to myocardial infarction (MI) but also described in other settings such as cardiac interventions or severe chest trauma. Owing to the limited data on its diagnosis, management, and outcomes, treatment strategies for IDH remain controversial. Case presentation: We present a case of a 53-year-old female who was initially misdiagnosed with Takotsubo cardiomyopathy and later found to have an IDH complicated by anticoagulation dilemmas and infection. Despite initial conservative management, progressive dissection and elevation of inflammatory markers prompted surgical intervention. The patient underwent endoventricular patch repair (Dor procedure), with successful resolution and functional recovery through rehabilitation. Conclusions: This case highlights the importance of keeping IDH in the differential diagnosis, especially in patients with non obstructive coronary findings or unexplained myocardial wall abnormalities. Multimodal imaging, especially cardiac MRI, plays a key role in confirming the diagnosis and determining the extent of dissection. Treatment should be highly individualized, balancing the risks of hematoma expansion against the need for anticoagulation when intracavitary thrombi are present. Infection risk can further complicate the clinical course, necessitating early recognition and intervention. When conservative management is no longer viable, surgical repair - such as the Dor procedure - can stabilize the myocardium and lead to meaningful recovery.
Keywords: Intramyocardial dissecting haematoma, Myocardial Infarction, cardiac imaging, surgical repair, case report
Received: 07 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Mervic, Cerne Cercek, Ovsenik, Kšela and Lipar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Luka Lipar, luka.lipar@gmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.