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A. Transthoracic echocardiography showed multiple abnormal cavities at both the right atrium (RA; red arrow) and left atrium (LA; blue arrow); B, C. Transesophageal echocardiography with color Doppler revealed abnormal flow in cavities around the RA and LA; D. Three-dimensional reconstruction of coronary computed tomography showed a bilateral giant coronary aneurysm; E, F. Coronary angiography revealed a combined giant coronary artery aneurysm with fistula communication to the coronary sinus (CS); LV : left ventricle; RV : right ventricle.
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Transthoracic echocardiography showed multiple abnormal cavities in both the right and left atria (Fig. 1A). Color Doppler in transesophageal echocardiography showed continuous color signal and flow in the abnormal cavity (Fig. 1B, C). In addition, coronary computed tomography revealed a giant bilateral coronary aneurysm (Fig. 1D). Coronary angiography confirmed a huge aneurysm at the left circumflex and right coronary artery with a fistula communicating with the coronary sinus (Fig. 1E, F).