Coronary artery aneurysms mimicking cardiac tumor

Anfinsen, Ole-Gunnar; Aaberge, Lars; Geiran, Odd; Smith, Hans‐Jørgen; Aakhus, Svend

doi:10.1016/j.euje.2004.02.003

Cited by 26 publications

(40 citation statements)

References 15 publications

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“…Complications such as thrombus formation, distal embolization and shunt formation and rupture can occur, 1,4,22,23 but the absolute risk is not known. 4 Myocardial infarction may also occur in the absence of significant coronary artery stenosis and is usually attributed to distal microembolization or thrombotic occlusion of an ectatic segment.…”

Section: Clinical Presentations and Diagnosismentioning

confidence: 99%

“…5 Coronary artery ectasias are classified according to the definition of Markis et al as follows: (1) diffuse ectasia with aneurysmal lesions in two vessels (type I), (2) diffuse ectasia in one vessel and discrete ectasia in another (type II), (3) diffuse ectasia in one vessel (type III), and (4) discrete ectasia in one vessel (type IV). 6 The proximal and middle segments of the right coronary artery (RCA) are the most common sites for CAE (68%), followed by the proximal left anterior descending (LAD) (60%) and the left circumflex arteries (LCx) (50%); 1 Coronary artery ectasia of the left main stem (LMCA) is rare 1,4 and occurs in only 0.1% of the population. 7,8 Coronary artery ectasia appears when the atherosclerotic process affects both the intima, forming luminal stenoses or occlusions, and the media and advantitial parts of the vessel wall resulting in arterial remodeling and dilatation.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 Coronary artery ectasia appears when the atherosclerotic process affects both the intima, forming luminal stenoses or occlusions, and the media and advantitial parts of the vessel wall resulting in arterial remodeling and dilatation. 4 The most common cause of CAE is atherosclerosis, 1 but aneurysms may also be congenital, mycotic, or part of a systemic inflammatory disease such as polyarteritis nodosa or the mucocutaneous lymph node syndrome of Kawasaki. 4 Table I summarizes the etiologies of CAE and their approximate frequencies.…”

Section: Introductionmentioning

confidence: 99%

“…4 The most common cause of CAE is atherosclerosis, 1 but aneurysms may also be congenital, mycotic, or part of a systemic inflammatory disease such as polyarteritis nodosa or the mucocutaneous lymph node syndrome of Kawasaki. 4 Table I summarizes the etiologies of CAE and their approximate frequencies.…”

Section: Introductionmentioning

confidence: 99%

“…1 Aneurysmal coronary disease has also been termed coronary artery ectasia (CAE), 2 defined as localized or diffuse nonobstructive lesions of the epicardial coronary arteries 2,3 that exceed the diameter of the normal adjacent segments or the patient's largest coronary vessel. 4 Based on the Coronary Artery Surgery Study (CASS) registry, definition of CAE is a dilatation with a diameter of ≥ 1.5 times the adjacent normal coronary artery. 2 Coronary artery ectasia is classified as saccular when the transverse diameter is greater than the longitudinal dimension or fusiform and when it is less than the longitudinal dimension.…”

Section: Introductionmentioning

confidence: 99%

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Coronary artery aneurysm: A review

Pahlavan

Niroomand

2006

Clinical Cardiology

186

201

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Summary: Coronary artery ectasia (CAE) is found in 0.3-5% of patients undergoing coronary angiography. Atherosclerosis is the main cause, followed by Kawasaki disease and infectious emboli. The exact pathogenesis has not been diagnosed as yet, but an inflammatory process is underlying. Symptoms, if present, are usually related to myocardial ischemia. Angiography is the mainstay for diagnosis. The prognosis is generally favorable. Thromboembolic complications are rare with antiplatelet therapy, and spontaneous rupture generally is rare but occurs more commonly in Kawasaki disease. Management varies from antithrombotic therapy to surgical ligation. Controlling coronary heart disease risk factors sharply affects the prognosis in patients with CAE.

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Section: Clinical Presentations and Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Coronary artery aneurysm: A review

Pahlavan

Niroomand

2006

Clinical Cardiology

186

201

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Angeborene Anomalien des Koronararteriensystems und Koronarerkrankungen bei Kindern und Jugendlichen

Haas

2010

Herzchirurgie

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Multiple Coronary Artery Aneurysms Detected by Cardiac Magnetic Resonance Imaging

Bernhardt

Spiess²,

Hombach

2007

Herz

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A 46-year-old male with acute coronary syndrome and signs of anteroseptal myocardial infarction without ST elevation on ECG (NSTEMI) presented for admission to hospital. Troponin I was elevated to 4.15 µg/l. Treatment with isosorbide dinitrate was initiated and led to resolution of symptoms.No wall motion abnormalities, signs of inducible myocardial ischemia by adenosine stress first-pass or myocardial necrosis could be visualized by cardiac magnetic resonance imaging. An additionally performed magnetic resonance coronary angiography showed multiple aneurysms in the proximal and middle segments of the left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA; see Figure 1). A 1.5-T (Intera, Philips Medical Systems, Best, The Netherlands) magnetic resonance system was therefore used with a navigator-based steady-state free-precession three-dimensional whole-heart SSFP sequence (TR 3.8 ms, TE 1.9 ms, voxel size 0.9 × 0.9 × 2.0 mm, fat suppression, T2prep echo time 50 ms, trigger delay individually optimized dependent on diastolic rest determined with a standard functional protocol). For reconstruction we used the Soapbubble Tool 5.0 for PRIDE4 (Philips Medical Systems). We thus diagnosed embolic myocardial infarction probably due to coronary thrombi.On coronary X-ray angiography these findings could be confirmed ( Figure 2). Furthermore, coronary thrombi or occluded peripheral coronary arteries could be excluded. 3 days after admission troponin I had decreased to 1.42 µg/l. A combined anticoagulation treatment with acetylsalicylic acid (100 mg/day) and phenprocoumon (target INR [International Normalized Ratio] range 2.0-3.0) was initiated. Furthermore, the medical treatment was extended with a β-blocker, an ACE inhibitor, and a statin. A magnetic resonance follow-up study was initiated 3 months after first diagnosis and showed no progression of the aneurysms.The proximal and middle segments of the coronary arteries are the most common sites where coronary aneurysms are found [1]. Atherosclerosis is the most prevalent cause for coronary aneurysms [1, 2], but these could also be due to congenital, mycotic, or systemic inflammatory disease such as Kawasaki syndrome [3]. Figure 1. Cardiac magnetic resonance coronary angiography without contrast agent enhancement showing aneurysms of the LAD (1), LCX (2), and RCA (3), respectively.Figure 2. Coronary X-ray angiography of the left coronary arteries with verification of the aneurysms of LAD (1) and LCX (2).

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Coronary artery aneurysms mimicking cardiac tumor

Abstract: Giant coronary aneurysms are an important differential diagnosis for cardiac tumors.

Cited by 26 publications

References 15 publications

Coronary artery aneurysm: A review

Coronary artery aneurysm: A review

Angeborene Anomalien des Koronararteriensystems und Koronarerkrankungen bei Kindern und Jugendlichen

Multiple Coronary Artery Aneurysms Detected by Cardiac Magnetic Resonance Imaging

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