Rupture of right coronary artery aneurysm into the right atrium
Insights
A congenital coronary artery aneurysm ruptured into the right atrium, causing heart failure and myocardial infarction in a 63-year-old man. Surgical resection of the aneurysm led to a full recovery.
Area of Science:
- Cardiology
- Vascular Surgery
- Congenital Heart Disease
Background:
- A 63-year-old male presented with acute congestive heart failure.
- A continuous murmur was detected upon physical examination.
- The patient had a history of inferior myocardial infarction two years prior, with no murmurs noted at that time.
Observation:
- Coronary angiography revealed a right coronary artery aneurysm.
- The aneurysm was found to be in direct communication with the right atrium.
- The distal portion of the right coronary artery was occluded.
Findings:
- The patient underwent surgical resection of the right coronary artery aneurysm.
- Post-operative recovery was uneventful, and the patient remains well.
Implications:
- This case suggests a congenital origin for the coronary artery aneurysm.
- The aneurysm is proposed as the underlying cause of both the myocardial infarction and the subsequent rupture into the right atrium.
- Successful surgical management highlights the importance of identifying and treating such rare vascular anomalies.
Abstract:
A 63-year-old man presented with acute congestive heart failure and was found to have a continuous murmur. Two years earlier, he had an inferior myocardial infarct, when no murmurs were heard. Angiography showed a right coronary artery aneurysm communicating with the right atrium. The distal vessel was occluded. The aneurysm was resected and the patient remains well. It is proposed that this was a congenital aneurysm which led firstly to the myocardial infarct and finally ruptured into the right atrium.
Related Concept Videos
Chambers of the Heart
Deoxygenated blood from the body is received in the right...
Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
Cardiac Catheterization II: Right Heart Catheterization
Aortic Regurgitation I: Introduction
Aneurysm I: Introduction


