Coronary Aneurysm – ABC CARDIOL

ABCIC

Image

Idiopathic Multiple Coronary Artery Aneurysms

Case presentation

A 54-year-old patient with no previous medical history was evaluated in the cardiology clinic for chest pain with atypical characteristics. Due to a pretest probability of ischemic heart disease of 20%, a coronary computed tomography scan was performed, which showed a coronary aneurysm (10 × 11 mm) from the origin of the right coronary artery (RCA) to the mid-segment (, white arrow; ). In the RCA mid-segment, there was partial circumferential thrombosis with 50% lumen stenosis ( and ; , white asterisks). The rest of the RCA showed no coronary artery obstruction. A 9 × 9 mm aneurysm was also observed in the left main coronary artery extending to the bifurcation and proximal portion of the left anterior descending coronary artery, without significant lesions ( and , white arrows; ). A 5 × 6 mm aneurysm was also observed in the proximal left circumflex artery, without significant coronary lesions (, white arrow; ). The study was completed with a regadenoson stress cardiac magnetic resonance that was negative for inducible ischemia. Serologies and autoantibodies were also requested, and they were negative. The decision was made to initiate medical treatment with acetylsalicylic acid and atorvastatin. During the 6-month follow-up, the patient did not present coronary outcomes and remained asymptomatic.

A coronary artery aneurysm (CAA) is typically defined as a focal dilation of a coronary artery that exceeds 1.5 times the diameter of an adjacent normal segment, whereas coronary ectasia refers to a diffuse dilation involving at least 50% of the artery’s length. Giant coronary aneurysms, although rare, are classified as those measuring more than 20 mm in diameter. This distinction is clinically significant, as ectasia represents a more extensive and generalized involvement of the artery, whereas aneurysms are focal and may carry a different prognosis and management approach.

[…]

Read Full Article

ABCIC

Case Report

Giant Right Coronary Artery Aneurysm with Arteriovenous Fistula

Maria Eduarda Menezes de Siqueira et al. Mayra Isabel Dias Ana Claudia Vincezi Raudan Uski Luciano Figueiredo de Aguiar Filho

Introduction

Coronary artery aneurysm (CAA) is defined as a dilation that exceeds the normal diameter of the adjacent artery or the diameter of the patient’s largest coronary artery by 1.5 times. Some authors consider a giant coronary aneurysm when the diameter is > 20 mm, whereas the American Heart Association defines giant aneurysms as those > 8 mm. Giant CAA is a rare pathology with an approximate incidence of 0.02%. We report a case of giant right coronary artery aneurysm with fistula to the coronary sinus, appearing as a giant “mass”.

[…]

Read Full Article

ABCIC

Case Report

Coronary-cavitary Fistula with Aneurysm in its Path: Case Report of Percutaneous Treatment

Carlos Alberto de Jesus et al. Edileide de Barros Correia Líria Maria Lima da Silva Ibraim Masciarelli Francisco Pinto … Mercedes Del Rosario Maldonado Andrade Andrezza Lobo de Alencar Marcelo Silva Ribeiro

Abstract

The authors report the case of a 29-year-old, female patient with palpitations, chest pain, and dyspnea on exertion. The patient was diagnosed with right coronary fistula and underwent percutaneous correction of the fistulous tract with an Amplatzer prosthesis.

Read Full Article

ABCIC

Editorial

My approach to assess Kawasaki disease by echocardiogram

Andressa Mussi Soares

[…]

Read Full Article

ABC

Original Article

Association of C-Reactive Protein to Albumin Ratio in Patients with Isolated Coronary Artery Ectasia

Alper Sercelik et al. Okan Tanrıverdi Lutfu Askin Serdar Turkmen

Abstract

Background

Coronary artery ectasia (CAE) is defined as diffuse or localized dilatation of coronary artery lumen with a diameter of 1.5 to 2.0 times the adjacent normal coronary artery. The C-reactive protein to albumin ratio (CAR) is a useful inflammatory marker, which has been documented in coronary artery disease.

Objective

To analyze the association of CAE and CAR.

Methods

A case-control protocol was used in this study. We included 102 consecutive patients with isolated CAE without stenosis (56 men and 46 women; mean age 60.4 ± 8.8 years). The control subjects consisted of an equal number of sex and age matched patients with normal coronary arteries (55 men and 47 women; mean age 61.2 ± 9.1 years). Clinical features, laboratory findings, and medication use history were recorded. Student’s t test, Mann-Whitney U test, chi-square test, and linear and logistic regression analysis were performed. A 2-sided p < 0.05 was statistically considered significant.

Results

The CAR was increased in patients with CAE compared to the controls (32 and 16; p < 0.001). In addition, the CAR was found to be an independent predictor of CAE (OR = 2.202; 95% CI 1.184 – 5.365; p < 0.001).

Conclusion

In the present study, we determined that CAR levels were significantly higher in the CAE group than in the control group, and the CAR was significantly correlated with CAE. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Read Full Article

ABC

Case Report

Pregnancy in Woman with Kawasaki Disease and Multiple Coronary Artery Aneurysms

Walkiria Samuel Avila et al. Antônio Fernando Diniz Freire Alexandre Anderson de Sousa Soares Ana Neri Rodrigues Epitácio Pereira José Carlos Nicolau

Introduction

Kawasaki disease (KD), first described in 1967, is a systemic vasculitis of unknown cause. It is an important cause of cardiac diseases in children aged younger than five years. KD is an autoimmune disorder whose clinical features include high fever, exanthema, conjunctivitis, cervical linfadenopathy and peripheral edema. Laboratory tests are compatible with acute inflammatory condition.

KD predominantly affects the coronary arteries, which is the most important clinical manifestation of the disease, varying from dilation and stenosis to aneurysm (incidence of 5% in patients with adequate treatment, and 25% in untreated patients). Giant coronary artery aneurysms (CAAs), i.e., CAAs with diameters > 8 mm, are associated with increased risk of thrombosis, acute myocardial infarction (AMI) and sudden death.

[…]

Read Full Article

ABC

Case Report

Spontaneous Coronary Artery Dissection in Acute Coronary Syndrome: Report of a Series of Cases with 17 Patients

Ana Rita Godinho et al. Mariana Vasconcelos Vitor Araújo Maria Júlia Maciel

Introduction

Spontaneous Coronary Artery Dissection (SCAD) has prevalence of 0.2 to 1.1% of the total angiograms performed for Acute Coronary Syndrome (ACS)^, and mostly affects young women. The etiology is not fully known,^, but the term “spontaneous” excludes all dissections associated with interventions or trauma. Treatment varies from the conservative approach to revascularization, with a favorable long-term prognosis.

This study aimed to assess the characteristics, the clinical presentation, therapeutic approach and follow-up of cases of SCAD with ACS presentation during a period of 7 years.

[…]

Read Full Article

ABC

Image

ST Segment Elevation Myocardial Infarction in Coronary Arteries with Massive Ectasy

Ana Rita G. Francisco et al. José Duarte Miguel Nobre Menezes José Marques da Costa … Pedro Canas da Silva Fausto J. Pinto

A 69-year-old caucasian male with a history of hypertension, dyslipidemia, obesity and tobacco use was admitted due to an inferior ST-segment elevation myocardial infarction with two hours evolution. He was treated with aspirin, clopidogrel and unfractioned heparin, and an emergent transradial coronary angiography was performed. Ectasic dilatation of left main, left anterior descending and circumflex arteries were documented, with distal TIMI 2 flow (). The dominant right coronary artery (RCA) was massively dilated proximally and occluded in the mid segment ().

[…]

Read Full Article

ABC

Case Report

Coronary artery bypass graft (CABG) in the presence of coronary aneurysms

Jarbas J. Dinkhuysen et al. Andrea de Souza Nogueira Jose Viera Zarate Domingos Spina Neto Teresa Lola Pena Soria

This is the case of a patient with coronary aneurysms, who underwent CABG for surgical exclusion of these aneurysms, followed by implant of the bypass grafts to the arteries affected, with satisfactory short-term and long-term results.

Read Full Article

ABC

Case Report

Multiple aneurysms of aortocoronary saphenous vein grafts with fatal rupture

Fábio R. Távora et al. Jean Jeudy Allen P. Burke

Aortocoronary saphenous vein graft (SVG) aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.

Read Full Article