STEMI With a Massive Coronary Aneurysm: A Rare Finding With a Management Dilemma
Joel Ponte Monteiro1, Eduardo Flores-Umanzor2, Salvatore Brugaletta2
1Hospital Central do Funchal, Serviço de Cardiologia, Funchal, Portugal.
JACC. Case Reports
|July 28, 2021
Insights
An elderly patient experienced an inferior ST-segment elevation myocardial infarction. During treatment, a large aneurysm was discovered in the right coronary artery, presenting an unusual finding during cardiac intervention.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- An 83-year-old male patient with multiple comorbidities presented with acute inferior ST-segment elevation myocardial infarction.
- Myocardial infarction (MI) remains a leading cause of mortality worldwide, necessitating prompt and effective interventions.
Purpose of the Study:
- To report a rare case of a giant right coronary artery aneurysm discovered during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.
- To highlight the importance of recognizing incidental vascular abnormalities during acute coronary syndrome management.
Main Methods:
- The patient underwent primary percutaneous coronary intervention (PCI) for inferior ST-segment elevation myocardial infarction.
- Coronary angiography was performed to assess the infarct-related artery and visualize coronary anatomy.
Main Results:
- During PCI, a giant aneurysm of the right coronary artery was incidentally identified.
- The aneurysm's size and location posed potential challenges for intervention and long-term management.
Conclusions:
- Giant coronary artery aneurysms are rare but can be incidentally found during interventions for acute myocardial infarction.
- This case underscores the need for comprehensive angiographic assessment and consideration of associated vascular pathologies.
Abstract:
An 83-year-old man with significant background comorbidities was admitted with an inferior ST-segment elevation myocardial infarction. During primary percutaneous coronary intervention, a giant aneurysm is seen in the right coronary artery. (Level of Difficulty: Beginner.).
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