Aneurysms of the coronary arteries are rare events. In most cases, such abnormalities are clinically silent and, when they cause symptoms, there are dyspnea and/or angina. Our report describes a case presenting with dyspnea; the admission electrocardiogram demonstrated largely spread ischemia in the lower-lateral leads and myocardial necrosis in the inferior wall. Selective coronary angiography disclosed severe three-vessel disease; aortic angiography revealed a large vascular neoformation, partly thrombosed, with multilobes and a wide communication with the ascending aorta; the oxygen run showed a slight, non-significant ‘jump’ at the level of the right atrium, confirming a possible left-to-right shunt. On open chest surgery, these alterations were confirmed. The principal aneurysm (6–7 cm) originating in right auricle gave rise to a localized pseudoaneurysm above the superior vena cava; the other three aneurysmal structures were situated along the course of the right coronary artery. After 2 years of clinical and echocardiographic control, the patient is symptom-free under conventional medical treatment.
aDivisione Clinicizzata di Cardiologia, Azienda Ospedaliera ‘Maggiore della Carità’, Novara, Italy
bCardiologia Universitaria, Ospedale Borgo Trento, Verona, Italy
cDivisione di Cardiochirurgia, Azienda Ospedaliera ‘Maggiore della Carità’, Novara, Italy
Received 12 October, 2006
Revised 14 December, 2006
Accepted 21 December, 2006
Correspondence and requests for reprints to Andrea Rognoni, Divisione Clinicizzata di Cardiologia, Università degli Studi del Piemonte Orientale, Azienda Ospedaliera ‘Maggiore della Carità’, Corso Mazzini 18, 28110 Novara, Italy Tel: +39 0321 3733294; fax: +39 0321 3733407; e-mail: email@example.com