UNUSUAL ACCELERATED PROGRESSION OF SACCULAR ANEURYSMS IN AN ECTATIC RIGHT CORONARY-ARTERY

Localized aneurysmal dilation or ectasia of coronary arteries is a rel atively uncommon angio graphic finding, of which the pathophysiologica l mechanism remains speculative. The majority of patients diagnosed wi th this clinical entity usually present with angina pectoris. Furtherm ore, it is rare to find isolated ectasia or aneurysm dilation of the c oronary arteries in patients with no prior history of coronary artery disease. The natural course is usually slowly progressive. This case d emonstrates an unusual accelerated dilation of coronary saccular aneur ysms, within a year of diagnosis, in a patient who presented with new onset congestive heart failure. Although the diagnosis was made with c oronary angiography, both magnetic resonance imaging and transesophage al echocardiography were of critical diagnostic value to identify the size and extension of the aneurysms as well as the presence of intralu minal thrombi.