Coronary and intracerebral arterial aneurysms in a young adult with acute coronary syndrome.
A 21-year-old man with no known medical history presented with substernal chest pain. Serial 12-lead electrocardiography showed dynamic ST-segment elevations in the anterolateral leads. Emergent coronary angiography revealed diffuse coronary aneurysmal disease and thrombotic occlusion of the left anterior descending coronary artery. The patient underwent urgent coronary artery bypass grafting. Subsequent imaging showed intracerebral aneurysms that involved his right and left middle cerebral arteries. The incidence, multiple causes, and proposed mechanisms of coronary artery aneurysmal formation are discussed, as is the rare association of these lesions with extracardiac arterial aneurysms.This association between coronary and extracardiac aneurysms is a phenomenon that warrants further study to determine its prevalence and possible causes. Findings could influence recommendations for further screening of patients diagnosed with coronary aneurysmal disease.
: Division of Cardiology, University of California, Los Angeles, California 90095, USA. Datsunian@gmail.com
Eric H
EH
Yang
Nikhil
N
Kapoor
Ali
A
Gheissari
Steven
S
Burstein
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000787:Angina Pectoris / Q000209:etiology; D002533:Cerebral Angiography; D003323:Coronary Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004562:Electrocardiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis; D008297:Male; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult