Ramirez Joel L, Kratz Johannes R, Wieselthaler Georg M
Division of Adult Cardiothoracic Surgery, Department of Surgery, San Francisco, CA, USA.
Interact Cardiovasc Thorac Surg. 2018 Nov 1;27(5):787-789. doi: 10.1093/icvts/ivy166.
Giant coronary artery aneurysms are rare and have variable presentations, which range from an incidental finding to sudden death. We report a case of a female presenting with chest pain and signs of cardiac tamponade who underwent a computed tomography (CT) pulmonary embolus protocol and was found to have haemopericardium with accumulation of contrast adjacent to the aorta. She underwent emergent sternotomy and was found to have a ruptured giant right coronary artery aneurysm, which was ligated and bypassed. This report highlights the difficulty of diagnosing a ruptured giant coronary artery aneurysm via CT and provides valuable information on an atypical presentation.
巨大冠状动脉瘤较为罕见，表现多样，从偶然发现到猝死不等。我们报告一例女性患者，以胸痛和心脏压塞症状就诊，接受了计算机断层扫描（CT）肺动脉栓塞检查方案，发现心包积血且主动脉旁有造影剂积聚。她接受了紧急胸骨切开术，发现有一个巨大的右冠状动脉瘤破裂，遂进行了结扎和搭桥手术。本报告强调了通过CT诊断破裂巨大冠状动脉瘤的困难，并提供了关于非典型表现的有价值信息。
