Giant Intramyocardial Aneurysm in a Patient with Intercoronary Communication between the Left Circumflex Artery and Right Coronary Artery: A Case Report

Abstract

Coronary artery aneurysm is a rare disease. It occurs in the epicardial space, mostly along the course of major coronary arteries. Here, we report a case of a giant incidental aneurysm embedded in the basal posterior wall of the left ventricle. A 43-year-old woman was referred to our institution for the evaluation of cardiac palpitations that had been present from the previous 2 months. She reported no medical history (such as Kawasaki's disease or hypertension) or previous operative history. Echocardiogram and subsequent cardiac CT revealed a giant aneurysm in the left ventricle, with a direct fistulous connection to a dilated and tortuous left circumflex artery, which showed direct communication with the straight right coronary artery.

Intramyocardial echo‐free space with a turbulent flow within, suggestive of an aneurysmal coronary artery

“…A pseudoaneurysm in the LAD is another possible cause, albeit the patient had no history of any coronary intervention. While the exact cause of this type of coronary aneurysm has yet to be determined, congenital causes, local hemodynamics, and various connective tissue disorders have been considered 2–4 …”