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Thrombosed giant coronary artery aneurysm presenting as an intracardiac mass

G M Hirsch1, P J Casey, A Raza-Ahmad

  • 1Department of Surgery, Dalhousie University School of Medicine, Halifax, Nova Scotia, Canada. ghirsch@is.dal.ca

Insights

Giant coronary artery aneurysms are rare in adults. This case highlights fibromuscular dysplasia as a cause of a thrombosed giant right coronary artery aneurysm presenting as an intracardiac mass after myocardial infarction.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pathology

Background:

  • Giant coronary artery aneurysms (GCAAs) are uncommon in adults, often linked to childhood Kawasaki disease.
  • Coronary artery aneurysms require prompt diagnosis and management due to potential complications like thrombosis and rupture.

Observation:

  • A case of a thrombosed giant right coronary artery aneurysm was identified.
  • The aneurysm presented as an intracardiac mass following an inferior wall myocardial infarction.

Findings:

  • Histologic examination revealed fibromuscular dysplasia as the underlying etiology of the aneurysm.
  • This finding is significant as fibromuscular dysplasia is not a commonly recognized cause of GCAAs.

Implications:

  • This case expands the known etiologies of giant coronary artery aneurysms in adults.
  • Highlights the importance of considering fibromuscular dysplasia in the differential diagnosis of GCAAs, even in the absence of typical Kawasaki disease history.

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