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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

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Giant right coronary artery aneurysm on 64-MDCT

Sergio G Pasian1, Kiat T Tan, Visal Pen

  • 1Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. sgpasian@yahoo.com.br

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|October 16, 2009
PubMed

Insights

A giant atherosclerotic aneurysm of the right coronary artery was discovered in an 81-year-old woman. This large coronary artery aneurysm compressed multiple cardiac structures, including the right atrium and superior vena cava.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Echocardiography is a primary imaging modality for cardiac assessment.
  • Cardiac computed tomography-angiography (CCTA) provides detailed anatomical information of coronary arteries and surrounding structures.
  • Aneurysms of the coronary arteries, while rare, can lead to significant clinical complications.

Observation:

  • An 81-year-old woman presented with an incidental finding of an extracardiac mass on echocardiography.
  • Subsequent cardiac computed tomography-angiography (CCTA) was performed for further characterization.
  • CCTA revealed a giant aneurysm of the right coronary artery.

Findings:

  • The right coronary artery aneurysm measured 80 mm in maximal diameter.
  • The giant aneurysm was causing significant mass effect on adjacent cardiac structures.
  • Compression was noted on the right atrium, right atrial appendage, proximal superior vena cava, right ventricle inlet, and tricuspid annulus.

Implications:

  • Giant coronary artery aneurysms are rare and require accurate diagnosis and characterization.
  • The mass effect from large aneurysms can lead to hemodynamic compromise and cardiac dysfunction.
  • Multimodality imaging, including CCTA, is crucial for evaluating the extent and impact of coronary artery aneurysms.

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