Mechanical and pharmacologic treatment in a patient with a coronary artery aneurysm and acute coronary syndrome

Korosoglou, Grigorios; Eisele, Tom; Nunninger, Peter; Giuşcă, Sorin

doi:10.1097/mca.0000000000000475

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Some investigators have used rivaroxaban at low doses (15 mg once daily) in similar cases. 12 Other surgical options comprise aneurysm ligation, resection, or bagged implant transplantation. 13 …”

Section: Discussionmentioning

confidence: 99%

Sudden cardiac death caused by a right coronary artery aneurysm complicated with acute myocardial infarction: a case report

Wu¹,

Shen²,

Ren³

et al. 2023

J Int Med Res

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Coronary aneurysms are defined as coronary artery ectasia (CAE) more than 1.5 times the normal adjacent segment diameter or the maximum coronary artery diameter. Although most CAE patients are asymptomatic, some patients present with acute coronary syndrome (ACS), such as angina pectoris, myocardial infarction (MI), and even sudden cardiac death. Sudden death due to coronary artery dilatation is very rare. However, we report a case of a patient with aneurysm-like dilatation of both the left and right coronary arteries, with acute inferior ST segment elevation myocardial infarction and sudden death due to third-degree atrioventricular block. After cardiopulmonary resuscitation, the patient underwent emergency coronary intervention. After thrombus aspiration and intracoronary thrombolysis in the right coronary artery, the atrioventricular block returned to normal on the fifth day of hospitalization. Following anticoagulant therapy, coronary angiography was repeated and showed that the thrombus had disappeared. The patient is recovering well after active rescue at the time of writing.

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Section: Discussionmentioning

confidence: 99%

Sudden cardiac death caused by a right coronary artery aneurysm complicated with acute myocardial infarction: a case report

Wu¹,

Shen²,

Ren³

et al. 2023

J Int Med Res

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“…In another case report (7), a 75-year-old patient with inferior ST elevation myocardial infarction and CAA was treated with a combination of aspirin, prasugrel, and very low-dose rivaroxaban (2.5 mg twice a day). In another 2 studies, Korosoglou et al (8) documented the use of rivaroxaban 15 mg with aspirin and clopidogrel in a 73-year-old female with acute coronary syndrome and coronary aneurysm, and Yan et al (9) documented the use of rivaroxaban 20 mg and aspirin in a 33-year-old man with acute myocardial infarction and coronary aneurysm but no evidence of vessel occlusion. Finally, Esenboğa et al ( 10) demonstrated short-term use of apixaban in 2 patients with non-ST elevation myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Thromboembolic ST elevation myocardial infarction due to a large coronary aneurysm: Role of apixaban

CHERUBINI¹,

Sciahbas²,

Cera³

et al. 2021

The Anatolian Journal of Cardiology

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“…In cases where residual thrombus remains in the artery despite aspiration, some authors advocate for triple therapy (dual antiplatelet treatment and an anticoagulant). Low-dose rivaroxaban (15 mg once daily) has been suggested [ 12 ]. There are insufficient data regarding the revascularization of stenotic ectatic coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Case Report and Literature Review

et al. 2019

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In the present study, we report a case of multiple coronary artery ectasias (CAE) and multiple intracranial arterial dolichoectasias (IADEs). A 60-year-old female presented to the emergency department twice with chest pain and mild elevation of troponin and T-wave changes. Peripheral coronary angiography showed severe ectasia and stenosis of certain segments of the left main coronary artery (LMCA), left anterior descending (LAD), first obtuse marginal (OM1), distal left circumflex (LCX), and bilateral subclavian arteries. The patient was treated medically. Two weeks later, she presented with dizziness. Head computerized tomography (CT) angiography showed severe IADE involving the vertebrobasilar system, intracranial internal carotid arteries, and bilateral middle cerebral arteries. No neurovascular intervention was performed due to the complexity of the findings. CAE is an abnormal dilatation of a coronary artery segment of at least 1.5 times the size of a normal coronary artery. The slow flow phenomenon may lead to ischemia and thrombosis, which can result in acute coronary syndrome. IADE comprises a dilatation and elongation of the arteries that affects both the anterior and posterior cerebral circulation, often causing neurological complications such as ischemic stroke, intracranial hemorrhage, or compression of surrounding neural structures. We report this case due to the rarity of coexisting IADE and CAE. A rarefaction of elastic tissue of the media with degeneration of the internal elastic lamina, in addition to matrix metalloproteinase dysfunction, is a common pathological mechanism for this condition. The management of CAE and IADE is mostly conservative, essentially treating the risk factors and administering antiplatelet and anticoagulant agents. In some patients, angioplasty vs. surgical treatment may be applied.

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Mechanical and pharmacologic treatment in a patient with a coronary artery aneurysm and acute coronary syndrome

Cited by 5 publications

References 8 publications

Sudden cardiac death caused by a right coronary artery aneurysm complicated with acute myocardial infarction: a case report

Sudden cardiac death caused by a right coronary artery aneurysm complicated with acute myocardial infarction: a case report

Thromboembolic ST elevation myocardial infarction due to a large coronary aneurysm: Role of apixaban

The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Case Report and Literature Review

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