Open AccessGiant right coronary artery aneurysm. Case Report
Author(s) -
Benjamín Iván Hernández-Mejía,
Edison Ricardo Espinoza-Saquicela
Publication year - 2020
Publication title -
case reports
Language(s) - English
Resource type - Journals
ISSN - 2462-8522
DOI - 10.15446/cr.v6n1.82446
Subject(s) - medicine , aneurysm , right coronary artery , cardiology , coronary artery aneurysm , coronary sinus , acute coronary syndrome , radiology , angina , coronary artery disease , surgery , artery , kawasaki disease , myocardial infarction , coronary angiography
Coronary aneurysms are rare and are linked to drug abuse; symptomatology depends on the coronary anatomy. This is a case of acute coronary syndrome associated with a giant right coronary aneurysm.Case description: A 40-year-old male, with history of heroin and crack use since age 20, attended consultation due to dyspnea, stable angina and diaphoresis. An electrocardiogram showed ST segment overlay on the underside and troponin problems. A coronary catheterization was performed, which revealed apparent inconclusive aortato-right atrium fistula. Based on the findings, angiotomography and magnetic resonance imaging were performed, finding a giant right coronary aneurysm. The aneurysm was resected using extracorporeal circuit, femoral cannulation, moderate hypothermia, aortic cross-clamping and cardioplegia, and the right coronary artery was revascularized with the left internal saphenous vein. The patient had a satisfactory postoperative period and was discharged after 7 days.Conclusion: There is an important association between drug use and the development of coronary aneurysms. Aneurysm size makes diagnosis difficult, so complementary studies are necessary to establish a differential diagnosis. An appropriate surgical approach allows for a complete resection of the aneurysm and optimal coronary revascularization.