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From atherosclerotic coronary ectasia to aneurysm: a case report and literature review

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Abstract

In contrast to Kawasaki syndrome the formation of coronary aneuryms caused by atherosclerosis has hardly been demonstrated. We report on a 56-year old patient, admitted to our hospital for cardiovascular evaluation before carotid surgery. He had no anginal pain, but a history of coronary artery disease with previous anterior myocardial infarction. Angiography revealed a collateralized LAD occlusion. Myocardial scintigraphy only demonstrated fixed perfusion defects. Surprisingly, MR imaging revealed large coronary aneurysms of the RCX and RCA. Angiographic follow up showed a rapid progression of ectatic towards aneurysmatic coronary lesions within 3 years. General pathophysiological mechanisms promoting ectatic coronary artery disease as a structural failure of the atherosclerotic remodelling process itself and chronic dilatatory stimuli due to endogenous and exogenous factors are discussed.

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Authors and Affiliations

  1. Department of Cardiology and Angiology, , University of Bochum, Herne, Germany

    Gunnar Plehn, Marc van Bracht, Christian Zuehlke, Max Olav Schrage, Ingo Wickenbrock, Christian Perings & Hans-Joachim Trappe

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  1. Gunnar Plehn
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  2. Marc van Bracht
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  3. Christian Zuehlke
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  4. Max Olav Schrage
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  5. Ingo Wickenbrock
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  6. Christian Perings
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  7. Hans-Joachim Trappe
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Correspondence to Gunnar Plehn.

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Plehn, G., Bracht, M.v., Zuehlke, C. et al. From atherosclerotic coronary ectasia to aneurysm: a case report and literature review. Int J Cardiovasc Imaging 22, 311–316 (2006). https://doi.org/10.1007/s10554-005-9039-6

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  • DOI: https://doi.org/10.1007/s10554-005-9039-6

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