PMC6450233_01
Modified apical 4-chamber view, showing the coronary aneurysm in the atrioventricular groove, in connection with the right coronary artery
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F1
The right sections appeared normal in size and function; however, a round, smooth cystic, mobile mass was noted in the atrioventricular groove [Figure 1 and Video 1]. A modified 4-chamber view showed a possible connection between the RCA and the structure [Figure 1]; we supposed it was a CAA.
The right coronary artery aneurysm showed from subcostal view and its major diameters
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F2
It appeared saccular from subcostal view, 3.6 cm long and 2.7 cm wide, with a thick echodense border and hypoechoic content [Figure 2 and Video 2].
Angiography of the right coronary artery confirming the huge aneurysm; two critical stenoses are visible proximal and distal to the ectasia
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F3
A coronary angiography was performed the day after, confirming the presence of a giant aneurysm of the mid-RCA [Figure 3]; two critical stenoses were visualized proximal and distal to the ectasia.
Left coronary artery angiographic image demonstrating a 90% stenosis of mid-left anterior descending artery. This was the culprit lesion responsible for patient's angina and the anteroseptal hypokinesia at echocardiography. A 70% stenosis of proximal left circumflex coronary artery was also detected; this vessel had small caliper and distribution (not showed)
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F4
A 90% stenosis of mid-left anterior descending (LAD) artery was also detected in addition to a 70% stenosis of mid left-circumflex coronary artery; this vessel had, however, small caliper and distribution [Figure 4].