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Recurrent myocardial infarction caused by a giant coronary aneurysm

E Straumann1, U Niederhäuser, C Meili

  • 1Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland.

International Journal of Cardiology
|May 13, 1998
PubMed

Insights

A rare giant aneurysm of the right coronary artery caused a heart attack via a steal phenomenon. Balloon occlusion of the aneurysm artery restored blood flow, resolving the ischemia and leading to successful surgical repair.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Coronary artery aneurysms are rare but can lead to serious complications.
  • Aneurysms can cause myocardial infarction through mechanisms like coronary steal.
  • Giant aneurysms pose unique diagnostic and therapeutic challenges.

Observation:

  • A patient presented with an acute coronary syndrome.
  • Imaging revealed a giant aneurysm of the right coronary artery.
  • The aneurysm was causing a significant coronary steal phenomenon, leading to infarction.

Findings:

  • Emergency coronary angiography identified the aneurysm and steal phenomenon.
  • Successful occlusion of the aneurysm orifice with a balloon catheter restored coronary blood flow.
  • Subsequent aneurysmectomy was performed with good clinical outcome.

Implications:

  • This case highlights non-atherosclerotic causes of acute coronary syndromes.
  • Percutaneous coronary intervention with balloon occlusion can be a temporizing measure for coronary artery aneurysms causing steal.
  • Giant coronary artery aneurysms require prompt diagnosis and management to prevent life-threatening events.

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