IntroductionGiant coronary artery aneurysm is an extremely rare form of coronary artery disease. The most common cause of coronary artery aneurysms is atherosclerosis. Although it is usually asymptomatic, it may have various clinical presentations, including angina, myocardial infarction or sudden death.Case PresentationA 32-year-old woman presented with edema of the upper and lower limbs, palpitation, and chest pain, and was diagnosed with a giant right coronary artery aneurysm that had initially mimicked a mediastinal cyst. Although computed tomography (CT) suggested a mediastinal cyst, trans-thoracic echocardiography revealed an extra pericardial cyst. The definitive diagnosis of right coronary artery aneurysm was made based on CT angiography and coronary angiography findings. As treatment, aneurysmectomy was performed, and she was discharged on the sixth postoperative day with good general health condition.ConclusionsCoronary artery aneurysm should be a differential diagnosis in cases of mediastinal cyst and mass lesion.
Introduction: Statins are beneficial treatments for patients with cardiovascular disease; however the relation between dose and clinical outcomes has not been evaluated. Objectives: We compared the effects of high versus low-dose of rosuvastatin on postoperative outcomes in patients undergoing coronary artery bypass graft (CABG). Patients and Methods: In this randomized clinical trial study, patients undergoing open heart surgery were randomly divided into two groups of 76 (received 5 mg dose) and 84 (received 20 mg dose) in Heshmat hospital, in Rasht. The study was started during the hospitalization period and after discharge until one month. Data were obtained by demographic questionnaire, clinical and changes in laboratory tests based on pre- and post-surgery. To analyze the variables, paired sample t test was applied. P value ≤0.05 was taken as significant. Results: The ages of the participants were 58.36±7 and 59.5±9 years for the treatment with high and low dosages of rosuvastatin (20 mg and 5 mg) respectively (P = 0.28). AKI (acute kidney injury) as a primary outcome was not significantly different between the two groups (P>0.05). Secondary outcomes (changes in lipid profiles, new atrial fibrillation (AF), postoperative infection) were not significantly different between the two groups (P>0.05). However, the increased values of CK-MB were significantly more in high-dose rosuvastatin than in low-dose rosuvastatin treated group (P<0.05). Conclusion: In this study, we compared the effects of high versus low doses of rosuvastatin on postoperative outcomes such as AKI, new AF, infection and myocardial infarction (MI) in CABG surgery. We found rosuvastatin can associate with decreased occurrence of postoperative outcomes of CABG in which no significant differences between high versus low dose of this drug. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20180113038329N1; https://irct.ir/trial/29938; ethical code# IR.GUMS.REC.1396.368).
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