医学
内科学
心脏病学
川崎病
心肌梗塞
胸痛
动脉瘤
冠状动脉瘤
血管炎
放射科
右冠状动脉
急诊科
冠状动脉扩张
急性冠脉综合征
作者
Abdul Baqi,Pirbhat Shams,Intisar Ahmed,Muhammad Usman Tariq
出处
期刊:Case Reports
[BMJ]
日期:2021-05-24
卷期号:14 (5)
标识
DOI:10.1136/bcr-2020-239683
摘要
A 21-year-old man presented with chest pain, diaphoresis and dyspnoea. Electrocardiogram (ECG) showed inferior ST-elevation myocardial infarction. Troponin I was positive. Patient underwent left heart catheterisation, which revealed normal epicardial coronary arteries except for right coronary artery which could not be engaged. CT coronary angiogram was done, which revealed large right sinus of Valsalva aneurysm giving rise to a pinched out right coronary artery. Patient underwent composite graft replacement of aortic valve, aortic root and ascending aorta along with a saphenous vein graft to right coronary artery. He was discharged in stable condition on fifth postoperative day. Biopsy of the aneurysmal tissue was suggestive of vasculitic aetiology. There was no evidence of systemic vasculitis and Magnetic Resonance Angiography (MRA) screen was negative for Takayasu's arteritis. Our patient was, hence, diagnosed with clinically isolated aortitis leading to ST elevation myocardial infarction due to an unruptured sinus of Valsalva aneurysm.
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