[Intracavitary thrombus as a differential diagnosis of intramyocardial dissection].
R, M.B., J, C., & N, L. (2026). [Intracavitary thrombus as a differential diagnosis of intramyocardial dissection].. Medicina.
R MB, J C, N L. [Intracavitary thrombus as a differential diagnosis of intramyocardial dissection].. Medicina. 2026; PMID: 42604518
R MB, J C, N L. [Intracavitary thrombus as a differential diagnosis of intramyocardial dissection].[J]. Medicina. 2026.
@article{r2026,
author = {Meléndez Bernard R and Cabral J and Litwak N},
title = {[Intracavitary thrombus as a differential diagnosis of intramyocardial dissection].},
journal = {Medicina},
year = {2026},
note = {PMID: 42604518},
}
TY - JOUR AU - Meléndez Bernard R AU - Cabral J AU - Litwak N TI - [Intracavitary thrombus as a differential diagnosis of intramyocardial dissection]. T2 - Medicina PY - 2026 AN - PMID:42604518 ER -
We present the case of a 47-year-old man with ischemic cardiomyopathy and a previous extensive acute myocardial infarction (AMI), who had undergone multiple percutaneous coronary interventions and progressed to advanced heart failure. During evaluation as a candidate for cardiac transplantation, transthoracic echocardiography revealed an image compatible with either an intracavitary thrombus (ICT) or an intramyocardial dissection (IMD), a finding also identified on cardiac computed tomography. Due to progressive hemodynamic deterioration, cardiac magnetic resonance imaging could not be performed. Anticoagulation with unfractionated heparin was initiated, and follow-up imaging demonstrated complete resolution of the lesion, supporting the diagnosis of ICT. The patient subsequently underwent successful cardiac transplantation, and histopathological analysis of the explanted heart confirmed a partially organized ICT, ruling out IMD. This case underscores the importance of differentiating between these two entities, where multimodality imaging and temporal evolution play a fundamental role in guiding therapeutic decisions. Se presenta el caso de un hombre de 47 años con antecedentes de cardiopatía isquémica e infarto agudo de miocardio (IAM) anterior extenso, con múltiples angioplastias previas y evolución hacia insuficiencia cardíaca avanzada. Durante la evaluación como candidato a trasplante cardíaco, el ecocardiograma evidenció una imagen compatible con trombo intracavitario (TI) o disección intramiocárdica (DIM), hallazgo corroborado en la tomografía computarizada cardíaca. Debido al deterioro hemodinámico progresivo, no se pudo realizar resonancia magnética cardíaca. Se inició anticoagulación con heparina sódica y en el seguimiento se observó la desaparición completa de la imagen, apoyando el diagnóstico de TI. El paciente fue sometido a trasplante cardíaco exitoso y el análisis anatomopatológico del explante confirmó la presencia de TI parcialmente organizado, descartando la DIM. Este caso resalta la importancia del diagnóstico diferencial entre ambas entidades, en el que las imágenes multimodales y la evolución temporal son fundamentales para la aproximación terapéutica adecuada.