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[Giant coronary artery aneurysm in a patient with rheumatoid arthritis]

Erden Gülcü1, Enis Sağlam, Elif Gülcü

  • 1Department of Cardiology, Van Yüksek İhtisas Education and Research Hospital, Van, Turkey. erdengulcu@yahoo.com

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|January 20, 2012
PubMed

Insights

This case report details a rare instance of right coronary artery aneurysmation and occlusion in a patient with rheumatoid arthritis, successfully managed with medical therapy. It highlights a unique association between rheumatoid arthritis and coronary artery aneurysms.

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Medicine

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory disease.
  • RA is associated with increased cardiovascular risk, including coronary artery disease.
  • Coronary artery aneurysms are rare vascular abnormalities.

Observation:

  • A 52-year-old male with a 12-year history of RA presented with acute inferior myocardial infarction.
  • Coronary angiography revealed a large thrombus causing total occlusion and aneurysmatic dilatation (15-16 mm) of the right coronary artery.
  • No suitable stent was available for the dilated artery, and a large thrombus burden precluded immediate intervention.

Findings:

  • The patient was treated with medical therapy, including tissue plasminogen activator infusion and subsequent warfarin.
  • The patient's chest pain resolved, and follow-up angiography demonstrated TIMI 3 flow in the right coronary artery.
  • Literature review found no previously reported cases of aneurysmatic dilatation of the right coronary artery associated with rheumatoid arthritis.

Implications:

  • This case suggests a potential, previously unreported association between rheumatoid arthritis and the development of coronary artery aneurysms.
  • It underscores the importance of considering rare vascular complications in patients with chronic inflammatory conditions.
  • Further research is warranted to explore the potential link between RA and coronary artery aneurysms.

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