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Delineating anatomy and function with multimodality imaging: a case report of giant right coronary artery aneurysms

Kameel Kassab1, Mina Iskander1, Saurabh Malhotra1

  • 1Division of Cardiology, Department of Cardiology, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison Street, Room 3620, Chicago, IL 60612, USA.

European Heart Journal. Case Reports
|July 4, 2020
PubMed

Insights

Giant coronary artery aneurysms (CAAs) are rare. Multimodality imaging, including CT angiography and MRI, is crucial for diagnosing these aneurysms and assessing their impact on heart function.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Giant coronary artery aneurysms (CAAs) are rare cardiovascular conditions.
  • Associated with connective tissue diseases, arteritides, and atherosclerosis.
  • Multimodality imaging is vital for evaluation and hemodynamic assessment.

Observation:

  • A 58-year-old female presented with exertional dyspnea.
  • Computed tomography (CT) revealed right coronary artery (RCA) aneurysms.
  • Invasive coronary angiogram (ICA) confirmed two giant RCA aneurysms.

Findings:

  • Coronary CT angiography (CCTA) identified an additional distal RCA aneurysm with thrombosis.
  • Contrast-enhanced cardiac magnetic resonance imaging (CMR) showed reduced inferior wall perfusion.
  • CMR also revealed aneurysmal wall inflammation.

Implications:

  • Multimodality imaging accurately characterizes giant CAAs, including extent and thrombosis.
  • Reduced perfusion likely caused exertional symptoms.
  • Surgical resection with bypass grafting is the recommended management.
Abstract

Keywords:
CMRCase reportCoronary artery aneurysmMultimodality imaging

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