Kakinoki S, Sakuma I, Kanamori K, Kudo T, Kobayashi T, Anzai T, Yasuda H, Sakamoto S, Sakai K, Tanabe T
J Cardiogr. 1985 Mar;15(1):231-40.
A 46-year-old woman was admitted to our hospital for evaluation of oppressive chest pain and ECG abnormalities. Her ECG on admission showed old inferior myocardial infarction. Chest radiography on admission indicated cardiomegaly (cardiothoracic ratio was 60%). The echocardiogram showed compression of the right atrium, right ventricle, and tricuspid annulus by a tumor which was located between the liver and the heart. The tumor's echo density was heterogenous. Cardiac computed tomography showed compression of the tricuspid annulus by the tumor which was located anterior to the right atrium and the right ventricle. The tumor registered 65.1 HU and was not enhanced by contrast medium. These findings strongly suggested a giant right coronary aneurysm filled with thrombus, and this diagnosis was confirmed at surgery and pathologically. Coronary aneurysms are rarely diagnosed during life, and usually are incidental findings during coronary arteriography performed to evaluate myocardial infarction or angina pectoris. The coronary aneurysm of the present case was clearly and easily recognized using computed tomography and appeared as a pericardial tumor. Computed tomography may be helpful for observing the growth of tumor and thrombus formation within it.
