J Korean Soc Radiol.  2020 Jan;81(1):213-218. 10.3348/jksr.2020.81.1.213.

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

• Lee YH
• Park NH
• Park JY
• Kim SJ

• KMID: 2469196
• DOI: http://doi.org/10.3348/jksr.2020.81.1.213

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.

MeSH Terms

Adult
Aneurysm*
Arteries*
Coronary Aneurysm
Coronary Artery Disease
Coronary Vessel Anomalies
Coronary Vessels*
Female
Heart Ventricles
Humans
Multidetector Computed Tomography
Rare Diseases

Figure

• 

  Fig. 1 A giant intramyocardial aneurysm with intercoronary communication in a 43-year-old woman, presenting with palpitation for 2 months. A. Short axis view of echocardiogram shows a round, anechoic cystic mass (2.3 × 2.0-cm in size) at the basal posterior wall of the LV. B. Long axis view of the echocardiogram with color Doppler shows that the intracardial cystic mass does not communicate with the color-filled LV. C. An axial image of cardiac CT shows a round, intracardial cystic mass (arrow) without evidence of communication with the LV at the basal posterior wall of the LV. D, E. 3D reconstruction (D) and maximum intensity projection image (E) show a diffuse, dilated, and tortuous LCX (arrow) communicating with the intramyocardial coronary aneurysm (dashed arrow). F. 3D reconstruction image shows a direct communication (dashed arrow) between the dilated and tortuous LCX (arrow) and RCA (arrow) at the crux cordis. D = dimensional, LCX = left circumflex artery, LV = left ventricle, RCA = right coronary artery

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