Surgical treatment of intramyocardial dissecting hematoma—a case report and literature review

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.