title: Multiple Giant Coronary Artery Aneurysms: A Rare Cause of Sudden Cardiac Death.
abstract: Multiple giant aneurysms involving the coronary arteries are uncommon and rarely reported. In the presented case, a 63-year-old man with poorly controlled hypertension died suddenly. Gross autopsy examination showed multiple giant thrombus-filled coronary artery aneurysms, atherosclerotic coronary artery disease, and cardiomegaly. Histological sections of the coronary aneurysms showed atherosclerotic changes with both organized and fresh thrombus. Giant coronary aneurysm is defined as a segmental enlargement of a coronary artery with a diameter exceeding 20 mm or more. The main etiology of this nebulous entity is attributed to atherosclerosis and inflammatory or inherited connective tissue disorders with the remainder being congenital, infectious, or idiopathic. Before its cataclysmic presentation, when ruptured or thrombosed, giant coronary aneurysm usually has a silent clinical course. Sudden death owing to giant multiple coronary aneurysms is rare and mandates careful classification of the aneurysms and prudent search for autoimmune-mediated or genetically based factors for subsequent ancillary autopsy studies.
authors.affiliation: Department of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Janík
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Hejna
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Michaela
authors.initials: M
authors.lastname: Ublová
authors.affiliation: The Fingerland Department of Pathology, Faculty of Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Ivo
authors.initials: I
authors.lastname: Šteiner
mesh_terms: D006332:Cardiomegaly / Q000473:pathology; D003323:Coronary Aneurysm / Q000473:pathology*; D003324:Coronary Artery Disease / Q000473:pathology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged
keywords: autopsy; etiology; forensic pathology; forensic science; giant coronary aneurysm; sudden cardiac death