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Chest radiography showing left lower lobe consolidation, cardiomegaly, and a calcified mass in the left lung base.
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Initial work-up revealed a white blood cell count of 19,300 and a chest radiography (Figure 1) showed left lower lobe consolidation, cardiomegaly, and a calcified mass in the left lung base.
Electrocardiogram (EKG) showed sinus tachycardia with a rate of 114 with right axis deviation and nonspecific ST-T changes.
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Electrocardiogram (EKG) showed sinus tachycardia with a rate of 114 with right axis deviation and non-specific ST-T changes (Figure 2).
Two-dimensional transthoracic echocardiogram short axis view showing a large extracardiac mass (yellow arrows) alongside the left ventricle (red arrows).
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He was initially treated for pneumonia and subsequently underwent an echocardiogram (Figure 3) due to findings of cardiomegaly on the chest radiograph.
Computed tomographic scan shows a large mostly thrombosed proximal and mid left anterior descending artery (LAD) aneurysm (red arrows) measuring 7.7 cm in addition to a smaller calcified distal aneurysm (blue arrow). The opacified left main (LM) aneurysm is also seen.
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Computed tomographic scan of the chest (Figure 4) showed large mostly thrombosed proximal and mid left anterior descending artery (LAD) aneurysm measuring 7.7 cm in addition to a smaller calcified distal aneurysm which corresponds to the mass seen on the chest radiography.
Coronary angiography showing multiple aneurysms within the left main (LM) coronary artery and left anterior descending artery (LAD) with slow flow. The top arrows point to the large mostly thrombosed aneurysm and the lower arrows show the location of the smaller calcified distal aneurysm.
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Coronary angiography (Figure 5) confirmed the presence of multiple aneurysms within the left main coronary artery and LAD with slow flow.