DOI QR코드

DOI QR Code

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

우관상동맥과 좌회선지간 교통이 있는 환자에서 나타난 거대 심근내 동맥류: 증례 보고

  • Yu Hyun Lee (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine) ;
  • Noh Hyuck Park (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine) ;
  • Ji Yeon Park (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine) ;
  • Seon-Jeong Kim (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine)
  • 이유현 (한양대학교 의과대학 명지병원 영상의학과) ;
  • 박노혁 (한양대학교 의과대학 명지병원 영상의학과) ;
  • 박지연 (한양대학교 의과대학 명지병원 영상의학과) ;
  • 김선정 (한양대학교 의과대학 명지병원 영상의학과)
  • Received : 2019.04.15
  • Accepted : 2019.06.19
  • Published : 2020.01.01

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.

관상동맥류는 드문 질환으로 대개 주관상동맥의 주행을 따라 심외막공간에서 발생한다. 본 논문에서 우리는 우연히 발견된 좌심실의 하기저벽에 생긴 거대동맥류 사례를 보고하고자 한다. 가와사키병이나 고혈압을 비롯한 과거력이 없는 43세 여자 환자가 두 달간 지속된 심계항진을 주소로 내원하였다. 심초음파와 심장 컴퓨터단층촬영에서 좌심실에 거대동맥류가 있었고 이것은 좌회선지와 직접 동맥루를 이루었으며, 좌회선지는 우관상동맥과 교통하였다.

Keywords

References

  1. Abou Sherif S, Ozden Tok O, Taskoylu O, Goktekin O, Kilic ID. Coronary artery aneurysms: a review of the epidemiology, pathophysiology, diagnosis, and treatment. Front Cardiovasc Med 2017;4:24 
  2. Johnson PT, Fishman EK. CT angiography of coronary artery aneurysms: detection, definition, causes, and treatment. AJR Am J Roentgenol 2010;195:928-934 
  3. Jeudy J, White CS, Kligerman SJ, Killam JL, Burke AP, Sechrist JW, et al. Spectrum of coronary artery aneurysms: from the radiologic pathology archives. Radiographics 2018;38:11-36 
  4. Edwards NFA, Wijesekera VA, Anderson BA, Habibian M, Burstow DJ, Walters DL, et al. A rare case of a giant coronary sinus with focal aneurysm secondary to multiple fistulous connections arising from a dilated, tortuous left circumflex coronary artery. CASE (Phila) 2018;2:99-102 
  5. Gungor B, Gurkan U, Alper AT, Bolca O. Intramyocardial coronary aneurysm: a distinct clinical entity. Int J Cardiol 2011;153:e39-40 
  6. Oliveira MD, Cavalcanti RR, Kajita AH, Miranda T, Kajita LJ, Horta PE, et al. Direct communication between the left circumflex and the right coronary arteries: a very rare coronary anomaly circulation. Cardiovasc Diagn Ther 2016;6:87-91 
  7. Kwon SH, Kim EJ, Woo JS, Kim SJ, Youn HC, Oh JH. Communication between the right and circumflex coronary arteries discovered incidentally by multidetector computed tomography. J Korean Soc Radiol 2016;75:214-217 
  8. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990;21:28-40 
  9. Gur M, Yilmaz R, Demirbag R. Unidirectional communication between the circumflex and right coronary arteries: a very rare coronary anomaly and cause of ischemia. Int J Cardiovasc Imaging 2006;22:339-342 
  10. Kim SH, Kim DH, Choi WG, Woo SI, Choi IS, Kwan J, et al. Intercoronary communication between the circumflex and right coronary arteries coexisted with coronary vasospasm. Korean Circ J 2013;43:488-490