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Case Reports: Rare disease
Giant right coronary artery aneurysm in a dominant right system
  1. Shafaqat Ali1,
  2. Mahin Khan2,
  3. Faryal Farooq3 and
  4. Hameem Changezi4
  1. 1Department of Medicine, LSU Health Shreveport, Shreveport, Louisiana, USA
  2. 2Department of Cardiology, The Mount Sinai Hospital, New York City, New York, USA
  3. 3Department of Medicine, Allama Iqbal Medical College, Lahore, Punjab, Pakistan
  4. 4Department of Cardiology, McLaren Health Care Corp, Flint, Michigan, USA
  1. Correspondence to Dr Shafaqat Ali; shafaqat_231{at}yahoo.com

Abstract

Giant coronary artery aneurysms (GCAAs) are unusual and extremely rare. Due to their rarity, there is a lack of data on managing GCAAs. A man in his 70s who presented with worsening shortness of breath and bilateral lower extremity oedema was found to have non-ST elevation myocardial infarction. Coronary angiography showed a tortuous Shepherd’s crook right coronary artery with ectasia and a gigantic 4.5×4 cm saccular aneurysm in the mid-right coronary artery with limited flow to the distal vasculature. He subsequently underwent aneurysmal clipping and excision with coronary artery bypass grafting. GCAAs are usually silent and diagnosed incidentally but can also present with variable cardiac symptoms. Treatment options include medical management, percutaneous coronary angioplasty and surgery. As per limited available literature, surgical resection has shown favourable outcomes, especially in symptomatic GCAAs. The patient reported significant symptomatic improvement on the follow-up office visit.

  • cardiovascular medicine
  • interventional cardiology
  • ischaemic heart disease

https://doi.org/10.1136/bcr-2022-253980

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    Footnotes

    • Twitter @ShafAli_MD

    • Contributors The following authors were responsible for the drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SA, MK and FF. The following authors gave final approval of the manuscript: SA, MK and HC.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.