Dissecting intramyocardial hematoma with flexuous channel in myocardium masquerading as a ventricular pseudoaneurysm

We report a 58-year-old acute myocardial infarction patient with dissecting intramyocardial hematoma (DIH) disguised as a ventricular pseudoaneurysm. DIH with a flexuous and narrow channel in the myocardium was confirmed during the operation, which extended deeply into the periphery of the ventricular wall. This DIH connected with the left ventricle via a narrow-necked flexuous channel of the myocardial defect and looked like a bulged sac surrounded by a thin wall of myocadium. No pericardium effusion was seen. Based on this report, we believe that a DIH has plentiful variety and this specific kind of DIH should be differentially diagnosed with pseudoaneurysm.