Gao Hongli, Li Hongwei
Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Front Med (Lausanne). 2023 May 25;10:1187690. doi: 10.3389/fmed.2023.1187690. eCollection 2023.
Giant coronary artery aneurysms (GCAAs) were relatively rare. Little was known about its characteristics, its etiology and its therapy. GCAAs with multiple abdominal artery aneurysms (AAAs) were more unusual and rarer.
A 29-year-old female presented to our hospital with abrupt-onset abdominal pain in the left upper quadrant and then she died in 2018. In 2016, prior to this visit, she came to our department for intermittent retrosternal compression pain during rest or sports activities. Medical history showed she had a coronary artery aneurysm (CAA) in 2004. We found evidence of multiple coronary aneurysms with severe stenosis and multiple AAAs and coronary artery bypass grafting (CABG) was carried out. In combination with laboratory analysis, imaging studies, and pathological examination, CAA may result from the long-term effects of Kawasaki disease (KD). Finally, the patient died of a ruptured abdominal aneurysm.
We report a rare case of GCAAs with severe stenosis and multiple AAAs in a young woman with a history of KD-induced coronary aneurysm. Although the understanding of the optimal treatment strategy for GCAAs combined with multiple aneurysms was limited, we found that CABG was effective in the treatment of GCAAs in this patient. In the clinical treatment of patients with GCAAs, attention should be paid to the examination of systemic blood vessels.
巨大冠状动脉瘤（GCAAs）相对罕见。对其特征、病因及治疗了解甚少。合并多个腹主动脉瘤（AAAs）的GCAAs则更为罕见。
一名29岁女性因左上腹突发腹痛就诊于我院，于2018年死亡。2016年此次就诊前，她曾因休息或运动时间歇性胸骨后压榨性疼痛来我科就诊。病史显示她在2004年患有冠状动脉瘤（CAA）。我们发现了多个伴有严重狭窄的冠状动脉瘤及多个腹主动脉瘤的证据，并进行了冠状动脉旁路移植术（CABG）。结合实验室分析、影像学检查及病理检查，CAA可能是川崎病（KD）长期影响所致。最终，患者死于腹主动脉瘤破裂。
我们报告了一例年轻女性患有KD诱发的冠状动脉瘤并伴有严重狭窄及多个腹主动脉瘤的罕见GCAAs病例。尽管对合并多个动脉瘤的GCAAs的最佳治疗策略了解有限，但我们发现CABG对该患者的GCAAs治疗有效。在GCAAs患者的临床治疗中，应注意对全身血管的检查。
