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Giant Coronary Artery Aneurysm: A Successful Diagnosis [Case Report]

El Khoury, Michel; Anugu, Viswajit Reddy; Salmane, Chadi; Karam, Boutros; Imam, Mohammed; Warchol, Andrew
Coronary artery aneurysms (CAAs) are rare, with giant CAAs being even rarer. The precise pathophysiology of this phenomenon is still unknown. CAAs are seldom reported life-threatening abnormalities of the cardiovascular system. We herein present a case of a 74-year-old man who presented at the hospital complaining of chest pain. An adenosine thallium scan revealed a small, reversible defect in the inferior wall of the left ventricle extending into the apex, consistent with ischemia. Echocardiography uncovered a large right coronary artery (RCA) aneurysm, measuring 5.6 × 7.5 cm. Diagnostic coronary angiography confirmed the presence of a large RCA aneurysm and aneurysmal dilation of the left anterior descending and circumflex arteries with no flow-limiting lesions. A reversed saphenous vein interposition graft was placed from the ascending aorta to the right posterior descending artery. The RCA aneurysmal sac was resected and sent to pathology, which uncovered myxoid degeneration of the media as well as thrombus formation. No complications were encountered during the procedure. Early diagnosis is vital to avoid fatal complications of CAAs, and therapeutic approaches are currently individualized in view of absence of evidence-based management strategies.
PMCID:8759980
PMID: 35047266
ISSN: 2168-8184
CID: 5268262

Resolution of recurrent chest pain with resection of papillary fibroelastoma [Case Report]

Bhat, Tariq M; Asgarian, Kourosh T; Sadel, Scott M; Awasum, Michael; Warchol, Andrew
Papillary fibroelastoma (PFE) is a benign primary tumor of the heart usually originating from the heart valves. Nonvalvular fibroelastomas are rare, and reported cases have presented either incidentally or with cerebral embolic phenomena; none have reported recurrent anginal symptoms. We are reporting a case of a 53-year-old female with history of significant radiation exposure to the chest in the past, who presented with recurrent chest pain and was found to have left atrial nonvalvular PFE managed with surgical excision.
PMID: 21951034
ISSN: 0886-0440
CID: 160221