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Giant Coronary Artery Aneurysm: A Successful Diagnosis

Michel El Khoury1, Viswajit Reddy Anugu2, Chadi Salmane3

  • 1Internal Medicine, Northwell Health, New York, USA.

Cureus
|January 20, 2022
PubMed

Insights

Giant coronary artery aneurysms (CAAs) are rare cardiovascular abnormalities. This case highlights a large right coronary artery aneurysm successfully treated with bypass surgery and resection, emphasizing early diagnosis for better outcomes.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Pathology

Background:

  • Coronary artery aneurysms (CAAs) are uncommon, with giant CAAs being exceedingly rare and potentially life-threatening cardiovascular conditions.
  • The exact cause of CAAs remains unclear, necessitating further research into their pathophysiology.
  • Current management strategies for CAAs lack evidence-based guidelines, leading to individualized treatment approaches.

Observation:

  • A 74-year-old male presented with chest pain, exhibiting signs of myocardial ischemia on an adenosine thallium scan.
  • Echocardiography revealed a giant aneurysm of the right coronary artery (RCA), measuring 5.6 × 7.5 cm.
  • Coronary angiography confirmed the large RCA aneurysm and additional dilatations in the left anterior descending and circumflex arteries without significant stenosis.

Findings:

  • Surgical intervention involved a reversed saphenous vein interposition graft from the ascending aorta to the right posterior descending artery.
  • Pathological examination of the resected RCA aneurysm showed myxoid degeneration of the media and thrombus formation.
  • The patient experienced no complications following the surgical procedure.

Implications:

  • This case underscores the importance of early diagnosis of CAAs to prevent potentially fatal complications.
  • Individualized therapeutic strategies are crucial due to the absence of established, evidence-based management protocols for CAAs.
  • Further research is needed to elucidate the pathophysiology and establish standardized treatment guidelines for these rare vascular abnormalities.

Keywords:
coronary aneurysmcoronary artery angiographycoronary artery bypass graft surgerycoronary artery diseasecoronary artery ectasia (cea)

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