JACC. Case reports · 2025
ST-Segment Elevation Myocardial Infarction and Coronary Artery Pseudoaneurysm.
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Polat Esra, Erçişli Murat Abdulhamit, Mendi Mehmet Ali, Sakallı Sedat, Dondurmacı Engin, Onay Mehmet
Аннотация
BACKGROUND: Coronary artery pseudoaneurysms (CAP) are rare, especially without any history of coronary angioplasty and coronary bypass graft. The symptoms range from asymptomatic to cardiogenic shock. Because of its rarity and variable symptoms, patients with CAP should be treated with an individualized approach.
CASE SUMMARY: A 27-year-old man was admitted to the emergency department with chest pain. Electrocardiography revealed ST-segment elevation myocardial infarction in leads 2, 3, and AVF. Transthoracic echocardiography revealed a 5.5 × 4.6 cm mass filling the right atrium. Coronary angiography performed in a patient with persistent angina showed increased opacity in the right coronary artery after opaque injection in the region corresponding to the right atrium after the crux. The patient with persistent angina and hypotensive status underwent emergency surgery, and an intraoperative CAP was identified.
DISCUSSION: Coronary artery pseudoaneurysm (CAP) may be iatrogenic, due to musculoskeletal pathologies, genetic, and symptomatic depending on the location. Our patient showed that CAP can present with ST-segment elevation myocardial infarction without any etiology.
TAKE-HOME MESSAGE: A CAP is rare, but it can occur non-iatrogenically.
CASE SUMMARY: A 27-year-old man was admitted to the emergency department with chest pain. Electrocardiography revealed ST-segment elevation myocardial infarction in leads 2, 3, and AVF. Transthoracic echocardiography revealed a 5.5 × 4.6 cm mass filling the right atrium. Coronary angiography performed in a patient with persistent angina showed increased opacity in the right coronary artery after opaque injection in the region corresponding to the right atrium after the crux. The patient with persistent angina and hypotensive status underwent emergency surgery, and an intraoperative CAP was identified.
DISCUSSION: Coronary artery pseudoaneurysm (CAP) may be iatrogenic, due to musculoskeletal pathologies, genetic, and symptomatic depending on the location. Our patient showed that CAP can present with ST-segment elevation myocardial infarction without any etiology.
TAKE-HOME MESSAGE: A CAP is rare, but it can occur non-iatrogenically.