CONGENITAL CORONARY-ARTERY ANEURYSM - A R ARE CAUSE OF ACUTE MYOCARDIAL-INFARCTION

An 18-year-old female presented with acute posterior wall infarction a fter exercise stress. Coronary angiography showed an aneurysm of the p roximal right coronary artery partially occluded with thrombi, followe d by a complete occlusion of the vessel. The left coronary artery was normal. Despite immediate intracoronary thrombolysis she developed a l arge posterior wall necrosis. Angiographic follow-up revealed worsenin g left ventricular function but not progression of the aneurysmatic ec tasia. The diagnosis congenital coronary artery aneurysm was made sinc e there was no evidence for an atherosclerotic, infectious or inflamma tory vascular disease. The patient was treated conservatively and with in 2 years of follow-up the clinical course was uneventful.