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Case report: incidental finding of a giant cardiac mass

George Surguladze1, Amiran Baduashvili2, Ali Tamsen1

  • 1Southampton Hospital, Southampton, New York.

Methodist Debakey Cardiovascular Journal
|August 13, 2014
PubMed

Insights

Coronary artery fistula (CAF) can lead to giant coronary artery aneurysms (CAA). This case highlights a rare instance where a presumed right ventricular aneurysm was actually a giant CAA secondary to CAF.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Vascular Surgery

Background:

  • Coronary artery fistula (CAF) is a rare anomaly connecting coronary arteries to other vessels or chambers.
  • Coronary artery aneurysms (CAA) are a known complication of CAF, occurring in approximately 26% of cases.
  • Giant CAA is generally defined as a dilatation exceeding four times the reference vessel diameter.

Observation:

  • A 38-year-old patient was incidentally found to have a presumed large right ventricular aneurysm.
  • Diagnostic workup and subsequent open-heart surgery were performed.
  • Surgical findings revealed the presumed aneurysm to be a coronary artery fistula with an unruptured giant coronary artery aneurysm.

Findings:

  • The patient's presumed right ventricular aneurysm was definitively diagnosed as a giant coronary artery aneurysm.
  • The giant coronary artery aneurysm was found to be a complication of an underlying coronary artery fistula.
  • This case presents a rare clinical presentation and diagnostic challenge.

Implications:

  • This case underscores the importance of considering CAF as an etiology for large cardiac masses or aneurysms.
  • Accurate diagnosis is crucial for appropriate management and surgical planning of complex cardiovascular anomalies.
  • Further research may elucidate the specific mechanisms leading to giant CAA formation in the context of CAF.

Keywords:
coronary artery fistulagiant coronary aneurysmhealthyincidental finding

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