title: [Giant coronary artery aneurysm in a patient with rheumatoid arthritis].
abstract: A 52-year-old men with rheumatoid arthritis of 12-year history presented with severe chest pain. The electrocardiogram was consistent with acute inferior myocardial infarction. Transthoracic echocardiography showed increased left ventricular dimensions and hypokinesia in the inferolateral wall. Coronary angiography performed for percutaneous coronary intervention showed aneurysmatic dilatation (15-16 mm) and total occlusion of the right coronary artery by a large thrombus. As there was no stent available for dilated right coronary artery and due to the large thrombus burden, medical therapy was decided and tissue plasminogen activator infusion was started. The patient's chest pain progressively decreased. Coronary angiography performed on the fifth day of admission showed TIMI 3 flow in the right coronary artery. Warfarin was added to standard anti-ischemic treatment with a target INR of 2.5-3.0. Our literature search yielded no reported case of such aneurysmatic dilatation associated with rheumatoid arthritis.
authors.affiliation: Department of Cardiology, Van Yüksek İhtisas Education and Research Hospital, Van, Turkey. erdengulcu@yahoo.com
authors.forename: Erden
authors.initials: E
authors.lastname: Gülcü
authors.forename: Enis
authors.initials: E
authors.lastname: Sağlam
authors.forename: Elif
authors.initials: E
authors.lastname: Gülcü
authors.forename: Mehmet Yunus
authors.initials: MY
authors.lastname: Emiroğlu
mesh_terms: D000787:Angina Pectoris; D015906:Angioplasty, Balloon, Coronary; D001172:Arthritis, Rheumatoid; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003937:Diagnosis, Differential; D004452:Echocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy