Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain

Radiology Case Reports

article

Melissa G.Y. Lee¹  Jeffrey Lefkovits¹  Subodh B. Joshi¹  Michael Pearson¹  Nathan Better¹ 

[1] Department of Cardiology, The Royal Melbourne Hospital

关键词: Acute coronary syndrome;    Coronary artery aneurysm;    Case report;    Kawasaki disease;    Multi-modality imaging;   

DOI  :  10.1016/j.radcr.2022.11.043

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

We describe an unusual case of multi-vessel giant coronary artery aneurysms complicated by acute coronary syndrome despite escalation of therapy. A 65-year-old man with hypertension and hypercholesterolemia presented to clinic with atypical chest pain over 4 months. Outpatient computed tomography coronary angiography (CTCA) demonstrated giant coronary aneurysms involving all 3 major coronary arteries. Outpatient coronary angiogram findings were in concordance with the CTCA with no definite obstructive coronary disease. Myocardial perfusion imaging was normal. He was commenced on dual antiplatelet therapy (DAPT). At 6 months, he presented with chest pain and non-ST-elevation myocardial infarction. Repeat coronary angiogram demonstrated occluded first septal LAD branch which previously had aneurysmal dilatation. DAPT was changed to long-term oral anticoagulation. He remains well at 18 months. This case highlights the importance of multi-modality imaging in the diagnosis and workup of coronary artery aneurysms and challenges in management; an individualized approach is required.

【 授权许可】

CC BY|CC BY-NC-ND