Delayed Formation of a Massive Atrial Hematoma After Coronary Intervention Manifesting With an Isolated Cough: Multimodality Imaging and Outcome

Can J Cardiol. 2017 Dec;33(12):1736.e5-1736.e7. doi: 10.1016/j.cjca.2017.08.003. Epub 2017 Aug 16.

Abstract

Coronary artery perforation is a relatively rare but potentially life-threatening complication of percutaneous coronary intervention because it could result in cardiac tamponade; exceptionally, distal coronary perforation could cause an acute formation of a mural hematoma, which could also prove lethal without adequate management. We report an exceptional case of a 76-year-old man in whom an important left atrial hematoma formed progressively over weeks after a planned percutaneous coronary intervention and manifested with an isolated cough. Diagnosis was made using multimodality imaging. A conservative strategy was adopted and produced a favourable outcome.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / injuries*
  • Cough / etiology*
  • Diagnosis, Differential
  • Echocardiography
  • Echocardiography, Transesophageal
  • Follow-Up Studies
  • Heart Atria*
  • Hematoma / complications
  • Hematoma / diagnosis*
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Male
  • Multimodal Imaging / methods*
  • Percutaneous Coronary Intervention / adverse effects*
  • Postoperative Complications
  • Rupture
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / surgery
  • Time Factors
  • Tomography, X-Ray Computed
  • Vascular System Injuries / complications*
  • Vascular System Injuries / diagnosis