title: Spontaneous coronary artery rupture presenting as an acute coronary syndrome evolved in pseudoaneurysm and cardiac tamponade: Case report and literature review.
abstract: Spontaneous coronary artery rupture is a rare disorder that may develop early into a sudden death due to the abrupt evolution of the associated cardiac tamponade. In some cases the rupture is contained and a false aneurysm develops with slower evolution of clinical signs. The correct diagnosis of spontaneous coronary artery rupture deserves a high level of suspicion; frequently it may be missed because the time window of its evolution seems to be very short or signs of acute coronary syndrome sometimes can prevail, leading to delays in diagnosis or to misdiagnosis. We report the case of a patient presenting a giant pseudoaneurysm of the right coronary artery due to spontaneous coronary artery rupture without any underlying disease. Moreover we present a review of the few cases in the literature, offering a pathophysiological hypothesis linking the site of rupture and clinical presentation.
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Longobardi
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Severino
authors.initials: S
authors.lastname: Iesu
authors.affiliation: 2 Interventional Cardiology, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Baldi
authors.affiliation: 3 Cardiology, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Maio
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Panza
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Generoso
authors.initials: G
authors.lastname: Mastrogiovanni
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Masiello
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Itri
authors.affiliation: 4 Diagnostic Imaging Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Catello
authors.initials: C
authors.lastname: Lambiase
authors.affiliation: 5 Department of Cardiology and Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.affiliation: 3 Cardiology, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Piscione
authors.affiliation: 1 Cardiac Surgery, Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Benedetto
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D000328:Adult; D017541:Aneurysm, False / Q000150:complications* / Q000175:diagnosis; D006348:Cardiac Surgical Procedures; D002305:Cardiac Tamponade / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000072226:Computed Tomography Angiography; D003323:Coronary Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous
keywords: SCAR; acute coronary syndrome; cardiac tamponade; pseudoaneurysm; spontaneous coronary artery rupture