From atherosclerotic coronary ectasia to aneurysm: a case report and literature review

In contrast to Kawasaki syndrome the formation of coronary aneurysms caused by atherosclerosis has hardly been demonstrated. We report on a 56-year old patient, admitted to our hospital for cardiovascular evaluation before carotid surgery. He had no anginal pain, but a history of coronary artery dis...

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Bibliographic Details
Published inInternational Journal of Cardiovascular Imaging Vol. 22; no. 3-4; pp. 311 - 316
Main Authors Plehn, Gunnar, van Bracht, Marc, Zuehlke, Christian, Schrage, Max Olav, Wickenbrock, Ingo, Perings, Christian, Trappe, Hans-Joachim
Format Journal Article
LanguageEnglish
Published United States Springer Nature B.V 01.06.2006
Subjects
Contrast Media
Coronary Aneurysm - etiology
Coronary Aneurysm - pathology
Coronary Aneurysm - physiopathology
Coronary Angiography
Coronary Artery Disease - complications
Coronary Artery Disease - pathology
Coronary Artery Disease - physiopathology
Coronary Vessels - pathology
Dilatation, Pathologic
Gadolinium DTPA
Humans
Magnetic Resonance Imaging
Male
Middle Aged
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Summary:In contrast to Kawasaki syndrome the formation of coronary aneurysms caused by atherosclerosis has hardly been demonstrated. We report on a 56-year old patient, admitted to our hospital for cardiovascular evaluation before carotid surgery. He had no anginal pain, but a history of coronary artery disease with previous anterior myocardial infarction. Angiography revealed a collateralized LAD occlusion. Myocardial scintigraphy only demonstrated fixed perfusion defects. Surprisingly, MR imaging revealed large coronary aneurysms of the RCX and RCA. Angiographic follow up showed a rapid progression of ectatic towards aneurysmatic coronary lesions within 3 years. General pathophysiological mechanisms promoting ectatic coronary artery disease as a structural failure of the atherosclerotic remodelling process itself and chronic dilatatory stimuli due to endogenous and exogenous factors are discussed.
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ISSN:1569-5794
1875-8312
1573-0743
DOI:10.1007/s10554-005-9039-6