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A 56-year-old man with a history of old myocardial infarction and coronary artery bypass grafting was performed percutaneous coronary intervention to the totally occluded lesion of native left anterior descending artery. He developed a coronary arterial perforation that led to a large dissecting sub-epicardial hematoma. Emergent surgery was performed, and a large hematoma was removed from the sub-epicardial space. Continuous drainage of blood was observed after surgery, and the patient died due to the development of multiorgan dysfunction. An autopsy revealed an extensive sub-epicardial hematoma on the lateral wall of the left ventricle and broad necrosis of the myocardium in the lateral wall.

Cardiogenic Shock Caused by a Large Sub-Epicardial Hematoma Complicating Percutaneous Coronary Intervention