Presentation
Acute chest pain. Past history of AVR.
Patient Data
Ovalar linear calcifications are seen on the lateral chest x-ray, a lot harder to see on the PA. Those look like parietal calcifications; CT-scan is recommended to evaluate the calcifications further.
CT-scan shows an aneurysm which seem to originate from the proximal right coronary artery. The aneurysm collar is larger than it would be expected in a pseudoaneurysm. Coronary angiography could be done to further confirm the diagnosis.
Coronary angiography was performed to confirm the diagnosis. Canulation of the right coronary artery's ostium confirms opacification of a giant coronary artery aneurysm.
Case Discussion
Coronary artery aneurysms are rare in adults. Smaller aneurysms can be encountered with Kawasaki disease. The aneurysm was resected.