Rev. Bras. Cardiol. Invasiva.2017;25(1-4):52-3.
Limitation of coronary angiography in the evaluation of a coronary aneurysm
DOI: 10.31160/JOTCI2017;25(1-4)A0013
This case involves a 43-year-old asymptomatic male with systemic arterial hypertension, diabetes mellitus and chronic renal dialysis. Transthoracic Doppler echocardiography was performed to assess left ventricular function, and a mass adjacent to the right ventricle on the diaphragmatic surface was noted. Magnetic resonance imaging revealed a right coronary artery aneurysm located in the distal segment, with a diameter of 3.9 x 3.5 cm in its major axes, covered by an eccentric circumferential mural thrombus (). Coronary angiography revealed diffuse dilatation of the entire luminal segment of the right coronary artery with a maximum diameter of 8.02 mm that did not allow the angiographic diagnosis of coronary aneurysm ().
The present case reinforces the limitation of coronary angiography as a method of diagnostic imaging in the evaluation of coronary artery aneurysms, especially in the presence of mural thrombosis, as it underestimates its actual dimensions.
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