Giant Right Coronary Artery Aneurysm Detected by Transthoracic Echocardiography

Area of Science:

• Cardiology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Coronary artery aneurysms (CAAs) are uncommon vascular abnormalities, often linked to atherosclerosis.
• Diagnosis typically involves invasive or advanced imaging modalities like coronary angiography or CT/MRI.
• Transthoracic echocardiography is less commonly utilized for primary CAA diagnosis.

Observation:

• A rare case of a giant, isolated right coronary artery aneurysm (3.6 cm x 2.7 cm) was identified in an adult patient presenting with unstable angina.
• Transthoracic echocardiography, including contrast studies, was instrumental in detecting the aneurysm and excluding other diagnoses.
• Associated findings included left ventricular anterior-septal hypokinesia.

Findings:

• Coronary angiography confirmed the giant coronary artery aneurysm and revealed significant three-vessel coronary artery disease.
• The diagnostic accuracy of echocardiography in identifying this rare condition was highlighted.
• The patient underwent successful surgical treatment, including coronary artery bypass grafting and aneurysm exclusion.

Implications:

• This case underscores the potential diagnostic utility of echocardiography in identifying rare coronary artery aneurysms.
• Early and accurate diagnosis is crucial for timely management of CAAs and associated coronary artery disease.
• Multimodality imaging approaches may be necessary for comprehensive assessment and treatment planning.