Iatrogenic Crescentic Hematoma of the Right Sinus of Valsalva

Background Iatrogenic crescentic hematoma of the right coronary sinus is a rare complication after coronary angiography. It mimics aortic root dissection, easily triggering diagnostic confusion and unnecessary invasive interventions.Case summary A 60-year-old man developed this hematoma during coronary angiography. Multimodal imaging excluded aortic extension and secondary cardiac complications. The patient remained hemodynamically stable and received conservative management, with complete hematoma absorption seen at the 3-month follow-up.Discussion The 2 lesions share similar imaging manifestations, which frequently leads to misdiagnosis. This case summarizes characteristic differential imaging signs and supports conservative treatment, helping clinicians avoid inappropriate emergency cardiac procedures.Take-home message Multimodal imaging can distinguish this rare hematoma from aortic dissection; conservative therapy is safe for hemodynamically stable patients.