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Spontaneous interventricular septum dissecting hematoma with endocardial fibroelastosis: imaging, diagnosis, surgical therapy and 6-year follow-up outcomes.

Interventricular septum dissecting hematoma is a rare and fatal cardiac complication with various causes including myocardial infarction, surgery, interventional therapy and trauma (1-3). Although several cases of this condition have been reported among infants and children with congenital heart disease surgery (mainly for ventricular septal defect) (2,4,5), there is no report of spontaneous interventricular septum dissecting hematoma combined with endocardial fibroelastosis. Furthermore, controversy surrounds the treatment for interventricular septum dissecting hematoma. This study reports a rare case of spontaneous interventricular septum dissecting hematoma combined with development of endocardial fibroelastosis. This case highlights imaging appearances of echocardiography and cardiac magnetic resonance (MR) imaging and presents correlated surgical treatment. The case is further supported by a 6-year follow-up study with reports of echocardiographic imaging on a comparative basis.