Giant right coronary artery aneurysm

Case contributed by Dr Maxime St-Amant

Presentation

Acute chest pain. Past history of AVR.

Patient Data

Age: 65 years
Gender: Male

Chest x-ray

x_ray

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 chest

ct

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 angiogram

dsa

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.

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