Giant right coronary artery aneurysm in a dominant right system.
Shafaqat AliMahin KhanFaryal FarooqHameem ChangeziPublished in: BMJ case reports (2023)
Giant coronary artery aneurysms (GCAAs) are unusual and extremely rare. Due to their rarity, there is a lack of data on managing GCAAs. A man in his 70s who presented with worsening shortness of breath and bilateral lower extremity oedema was found to have non-ST elevation myocardial infarction. Coronary angiography showed a tortuous Shepherd's crook right coronary artery with ectasia and a gigantic 4.5×4 cm saccular aneurysm in the mid-right coronary artery with limited flow to the distal vasculature. He subsequently underwent aneurysmal clipping and excision with coronary artery bypass grafting. GCAAs are usually silent and diagnosed incidentally but can also present with variable cardiac symptoms. Treatment options include medical management, percutaneous coronary angioplasty and surgery. As per limited available literature, surgical resection has shown favourable outcomes, especially in symptomatic GCAAs. The patient reported significant symptomatic improvement on the follow-up office visit.
Keyphrases
- coronary artery
- pulmonary artery
- coronary artery bypass grafting
- percutaneous coronary intervention
- st elevation myocardial infarction
- minimally invasive
- patient reported
- coronary artery disease
- coronary artery bypass
- acute coronary syndrome
- systematic review
- left ventricular
- heart failure
- electronic health record
- skeletal muscle
- depressive symptoms
- machine learning
- ultrasound guided
- type diabetes
- metabolic syndrome
- atrial fibrillation
- big data
- sleep quality
- case report
- pulmonary hypertension
- pulmonary arterial hypertension
- transcatheter aortic valve replacement