Cargando…
Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain
We describe an unusual case of multi-vessel giant coronary artery aneurysms complicated by acute coronary syndrome despite escalation of therapy. A 65-year-old man with hypertension and hypercholesterolemia presented to clinic with atypical chest pain over 4 months. Outpatient computed tomography co...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793163/ https://www.ncbi.nlm.nih.gov/pubmed/36582756 http://dx.doi.org/10.1016/j.radcr.2022.11.043 |
_version_ | 1784859797926969344 |
---|---|
author | Lee, Melissa G.Y. Lefkovits, Jeffrey Joshi, Subodh B. Pearson, Michael Better, Nathan |
author_facet | Lee, Melissa G.Y. Lefkovits, Jeffrey Joshi, Subodh B. Pearson, Michael Better, Nathan |
author_sort | Lee, Melissa G.Y. |
collection | PubMed |
description | We describe an unusual case of multi-vessel giant coronary artery aneurysms complicated by acute coronary syndrome despite escalation of therapy. A 65-year-old man with hypertension and hypercholesterolemia presented to clinic with atypical chest pain over 4 months. Outpatient computed tomography coronary angiography (CTCA) demonstrated giant coronary aneurysms involving all 3 major coronary arteries. Outpatient coronary angiogram findings were in concordance with the CTCA with no definite obstructive coronary disease. Myocardial perfusion imaging was normal. He was commenced on dual antiplatelet therapy (DAPT). At 6 months, he presented with chest pain and non-ST-elevation myocardial infarction. Repeat coronary angiogram demonstrated occluded first septal LAD branch which previously had aneurysmal dilatation. DAPT was changed to long-term oral anticoagulation. He remains well at 18 months. This case highlights the importance of multi-modality imaging in the diagnosis and workup of coronary artery aneurysms and challenges in management; an individualized approach is required. |
format | Online Article Text |
id | pubmed-9793163 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-97931632022-12-28 Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain Lee, Melissa G.Y. Lefkovits, Jeffrey Joshi, Subodh B. Pearson, Michael Better, Nathan Radiol Case Rep Case Report We describe an unusual case of multi-vessel giant coronary artery aneurysms complicated by acute coronary syndrome despite escalation of therapy. A 65-year-old man with hypertension and hypercholesterolemia presented to clinic with atypical chest pain over 4 months. Outpatient computed tomography coronary angiography (CTCA) demonstrated giant coronary aneurysms involving all 3 major coronary arteries. Outpatient coronary angiogram findings were in concordance with the CTCA with no definite obstructive coronary disease. Myocardial perfusion imaging was normal. He was commenced on dual antiplatelet therapy (DAPT). At 6 months, he presented with chest pain and non-ST-elevation myocardial infarction. Repeat coronary angiogram demonstrated occluded first septal LAD branch which previously had aneurysmal dilatation. DAPT was changed to long-term oral anticoagulation. He remains well at 18 months. This case highlights the importance of multi-modality imaging in the diagnosis and workup of coronary artery aneurysms and challenges in management; an individualized approach is required. Elsevier 2022-12-19 /pmc/articles/PMC9793163/ /pubmed/36582756 http://dx.doi.org/10.1016/j.radcr.2022.11.043 Text en © 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Lee, Melissa G.Y. Lefkovits, Jeffrey Joshi, Subodh B. Pearson, Michael Better, Nathan Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain |
title | Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain |
title_full | Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain |
title_fullStr | Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain |
title_full_unstemmed | Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain |
title_short | Multi-vessel giant coronary artery aneurysms: An unusual cause of chest pain |
title_sort | multi-vessel giant coronary artery aneurysms: an unusual cause of chest pain |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793163/ https://www.ncbi.nlm.nih.gov/pubmed/36582756 http://dx.doi.org/10.1016/j.radcr.2022.11.043 |
work_keys_str_mv | AT leemelissagy multivesselgiantcoronaryarteryaneurysmsanunusualcauseofchestpain AT lefkovitsjeffrey multivesselgiantcoronaryarteryaneurysmsanunusualcauseofchestpain AT joshisubodhb multivesselgiantcoronaryarteryaneurysmsanunusualcauseofchestpain AT pearsonmichael multivesselgiantcoronaryarteryaneurysmsanunusualcauseofchestpain AT betternathan multivesselgiantcoronaryarteryaneurysmsanunusualcauseofchestpain |