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A case report of a giant coronary artery aneurysm masquerading as a ventricular mass

Sruti Prathivadhi-Bhayankaram1, Mahi L Ashwath1,2

  • 1Department of Internal Medicine, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.

European Heart Journal. Case Reports
|April 4, 2024
PubMed

Insights

Coronary artery aneurysms are rare but serious vascular conditions. This case highlights the importance of multimodal imaging in diagnosing these aneurysms, which can be mistaken for masses.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Coronary artery aneurysms (CAAs) are defined as dilations >1.5 times the diameter of the largest adjacent coronary vessel.
  • CAAs are rare, with a prevalence of 1.4-4.9%, and carry significant risks including thrombosis, myocardial infarction, and rupture.
  • Initial diagnostic imaging may misinterpret CAAs as ventricular masses.

Observation:

  • A patient presented with acute hypoxic respiratory failure, pulmonary edema, ventricular tachycardia, and myocardial infarction.
  • Further investigation revealed thrombosed aneurysms in the left anterior descending and circumflex arteries projecting into the right ventricle.
  • Multimodal imaging was crucial for accurate diagnosis.

Findings:

  • The patient's condition was diagnosed as coronary artery aneurysms with thrombotic complications.
  • The aneurysms were initially misidentified as a right ventricular mass on initial imaging.
  • The patient's diagnosis was confirmed using multimodal imaging techniques.

Implications:

  • Clinicians must maintain a high index of suspicion for CAAs, given their potential for severe complications and risk of misdiagnosis.
  • Multimodal imaging is essential for the accurate detection and characterization of coronary artery aneurysms.
  • Prompt diagnosis and appropriate medical management are critical for patients with coronary artery aneurysms.
Abstract

Keywords:
Case reportComputed tomographyCoronary artery aneurysmMultimodal imagingThrombosed aneurysmVentricular tachycardia

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