title: Spontaneous coronary artery rupture without a pericardial effusion: a diagnostic challenge.
abstract: Spontaneous coronary artery rupture (CAR) is an extremely rare, life-threatening entity. It is a challenge to make a diagnosis of CAR in the absence of pericardial effusion. We describe a case of a spontaneous rupture of the right coronary artery (RCA) without pericardial effusion that emphasises the benefit of high clinical suspicion and early diagnosis. A 60-year-old man was admitted to the emergency department, with inferior myocardial infarction. Echocardiogram was negative for a pericardial effusion. Coronary angiography revealed complete occlusion of the RCA with intraluminal dissection and extravasation of contrast into the epicardium at the mid-portion of the RCA, which suggested rupture of the RCA. The patient underwent uneventful emergency coronary artery bypass grafting. CAR should be considered as a differential diagnosis in patients with acute chest pain, even in the absence of pericardial effusion, particularly in case of inferior wall involvement.
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Utkan
authors.initials: U
authors.lastname: Sevuk
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Sertan
authors.initials: S
authors.lastname: Ozyalcin
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Firat
authors.initials: F
authors.lastname: Ayaz
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Kose
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion; D012422:Rupture, Spontaneous