گزارش يك مورد آنوريسم خيلي بزرگ

GIANT CORONARY ARTERY ANEURYSM: A CASE REPORT

Aneurysms in coronary arteries are rare entities; however, with potential severe complications. Atherosclerotic lesions account for the majority of cases of coronary aneurysm. The right coronary artery is the most frequently involved artery; followed by the left descending artery (LAD). The patient was a 73-year-old male with the history of typical pectoris angina. Coronary angiography revealed a giant coronary artery aneurysm arising from the proximal segment of LAD and measuring 40 and 28 mm in diameter, as well as, significant stenosis of the LAD, RCA and LCX. Atrial fibrillation (Af) was accompanied with chest pain occurring immediately after coronary angiography. It was controlled with medical treatment so normal sinus rhythm occurred. Although most patients with coronary aneurysms are asymptomatic, manifestations of myocardial ischemia may occur. They are usually diagnosed incidentally during investigation for ischemic heart diseases. In spite of controversial persist regarding the use of management aneurysm; no doubt that surgical therapy is reserved for caseas with large aneurysm or with myocardial ischemia due to significant coronary artery stenosis. Literature review showed no atrial fibrillation after coronary angiography in coronary aneurysm. We recommended cardiac monitoring after coronary angiography in patient with coronary aneurysm.