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[A 60-year-old woman with asthenia and dyspnoea]

Pirouz Badr1, Frank E Sørgaard, Jan L Svennevig

  • 1Seksjon for hjertesykdommer, Medisinsk avdeling, Akershus universitetssykehus, 1478 Lørenskog. pirouz.badr@rikshospitalet.no

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|March 16, 2005
PubMed

Insights

Coronary artery aneurysms are rare but can cause serious complications like heart attack. This case highlights a large right coronary aneurysm misdiagnosed initially, emphasizing the need for accurate diagnosis and management strategies.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Coronary artery aneurysms (CAAs) are uncommon, affecting 1.5-4.9% of patients undergoing angiography.
  • Common causes include arteriosclerosis, Kawasaki disease, and connective tissue disorders.
  • Most CAAs are asymptomatic, but complications like thrombosis, myocardial infarction, and thromboembolism can occur.

Observation:

  • A 60-year-old female presented with transient ischemic attack, fever, nausea, vomiting, and lower extremity ecchymoses.
  • Initial echocardiography suggested a right atrial tumor.
  • Surgical exploration revealed a large right coronary aneurysm and an atrial septum defect.

Findings:

  • The patient's symptoms were attributed to a large right coronary aneurysm, not an atrial tumor.
  • An incidental finding of an atrial septum defect was also noted during surgery.

Implications:

  • This case underscores the importance of considering CAAs in the differential diagnosis of cardiac masses and neurological events.
  • Accurate diagnosis is crucial for appropriate management, which remains debated, involving medical or surgical options.
  • Further research into CAA management strategies is warranted.

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