Journal Information
Vol. 47. Issue 3.
Pages 181-182 (March 2023)
Vol. 47. Issue 3.
Pages 181-182 (March 2023)
Images in Intensive Medicine
Full text access
Utility of the strain in the management of acute coronary syndrome: Report of clinical case of a spontaneous hematoma of coronary artery
J. Navarro Martínez
Corresponding author

Corresponding author.
, M. García Valiente, I. Keituqwa Yáñez
Unidad de Cuidados Intensivos y Electroestimulación Cardiaca, Hospital General Universitario Rafael Méndez, Lorca, Murcia, Spain
This item has received
Article information
Full Text
Download PDF
Figures (3)
Show moreShow less
Additional material (5)
Full Text

This is the case of a 42-year-old man with chest pain with negative T waves in both III and aVF leads on the EKG (Fig. 1). The patient was admitted to our intensive care unit where he presented with a new episode of central-thoracic pain with transient ST-segment elevation in the inferior leads of the EKG (Fig. 1) and negative high-sensitivity troponin. The echocardiogram performed revealed a left ventricular ejection fraction of 58% (Appendix B; videos 1, 2, and 3) without contractility alterations. However, the study of the left ventricular (LV) longitudinal strain of the inferior side was impaired with a LV longitudinal global strain of −18% (Fig. 2). The coronary angiography performed revealed the presence of severe stenosis on theright coronary artery middle segment (Fig. 3; Appendix B; video 4) due to intramural hematoma without dissection as seen on the optical coherence tomography (Fig. 3). A stent was implanted in such artery (Appendix B; video 5) with favorable progression.

Figure 1.

Electrocardiogram of the patient in the emergency room.

Figure 2.

Patient's strain.

Figure 3.

Cardiac catheterization and Optical coherence tomography (OCT).

Appendix A
Supplementary data

The following are Supplementary data to this article:


Copyright © 2021. Elsevier España, S.L.U. and SEMICYUC
Medicina Intensiva (English Edition)
Article options
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?