Coronary artery aneurysms with giant thrombosed right coronary aneurysm
Diagnosis certain
Presentation
Inferior myocardial infarction. Incidental findings at coronarography.
Patient Data
Age: 45 years
Gender: Female
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LAD:
- -proximal 10mm aneurysm
- -mid segment: 10mm aneurysm with partial thrombosis and parietal calcifications. No stenosis
- -at mid-distal junction: 6mm aneurysm
- -1st diag has a 5mm aneurysm
Cx
- -proximal 18mm aneurysm with partial thrombosis and wall calcifications, no stenosis.
- -mid: 8mm aneurysm
- -marginal branch hardly opacified
RCA
- Shallow lumen, pre-occlusive stenosis of proximal and middle segments.
- Proximal 10mm aneurysm with complete thrombosis
- Mid segment: thrombosed 7mm aneurysm
- Mid-distal junction: giant 21mm aneurysm, complete thrombosis
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LAD:
- -proximal 10mm aneurysm
- -mid segment: 10mm aneurysm with partial thrombosis and parietal calcifications. No stenosis
- -at mid-distal junction: 6mm aneurysm
- -1st diag has a 5mm aneurysm
Cx
- -proximal 18mm aneurysm with partial thrombosis and wall calcifications, no stenosis.
- -mid: 8mm aneurysm
- -marginal branch hardly opacified
RCA
- Shallow lumen, pre-occlusive stenosis of proximal and middle segments.
- Proximal 10mm aneurysm with complete thrombosis
- Mid segment: thrombosed 7mm aneurysm
- Mid-distal junction: giant 21mm aneurysm, complete thrombosis
Case Discussion
Coronary arteries aneurysms can be associated with Takayasu arteritis, periarteritis nodosa, Kawasaki vasculitis, lupus, etc. These are not false aneurysms, hence mycotic aneurysms seem unlikely.
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