title: Rupture of massive coronary artery aneurysm resulting in cardiac tamponade.
abstract: Coronary artery aneurysm is a fairly uncommon clinical entity, which is defined by a characteristic dilatation that exceeds 1.5 times the width of normal adjacent coronary artery segments. In the present report, we describe a case of rupture of a massive coronary artery aneurysm. A man in his 40s was found dead in his bed. The pericardial cavity contained 270mL of blood with 428.2g of coagulation. Two true aneurysms of the right coronary artery were identified. A proximal aneurysm, adjacent to the right auricle, had ruptured on the right. A distal unruptured aneurysm was identified 5.1cm distal to the proximal ruptured aneurysm. Atherosclerosis of the coronary arteries and aorta was severe. The heart weighed 799.1g and showed concentric ventricular hypertrophy, myocardial thinning, and patchy fibrosis. Histological analysis showed that both aneurysms were purely atherosclerotic true aneurysms without considerable inflammation. The cause of death was determined as cardiac tamponade due to rupture of a giant coronary atherosclerotic aneurysm.
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: kondo@med.kobe-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Motonori
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Azumi
authors.initials: A
authors.lastname: Kuse
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Morichika
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakurada
authors.affiliation: Department of Legal Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Migiwa
authors.initials: M
authors.lastname: Asano
authors.affiliation: Division of Legal Medicine, Department of Community Medicine and Social Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ueno
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000473:pathology; D002305:Cardiac Tamponade / Q000209:etiology*; D002423:Cause of Death; D003323:Coronary Aneurysm / Q000150:complications* / Q000473:pathology; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology
keywords: Cardiac tamponade; Coronary artery aneurysm; Rupture