[Morphology of the coronary arteries following percutaneous transluminal coronary angioplasty with hemopericardium].

Autopsy findings in a patient with cardiac tamponade following percutaneous transluminal coronary angioplasty (PTCA) are reported. Angiography during PTCA demonstrated coronary dissection without extravasation of contrast medium at the site of angioplasty. Histologic examination of the dilated coronary segment revealed longitudinal splitting of intima and media as well as circumferential subintimal and submedial dissection. Hemorrhage into plaque, intima, media, adventitia and dissection lumina was found. Disruption of the adventitia was not present. Cardiac tamponade may occur transadventitially without complete disruption of the coronary artery and without extravasation of contrast medium.