PMC3232573_01
Parasternal short axis view at the level of the papillary muscles during the acute phase, demonstrating a small posterior pericardial effusion. The left ventricular contractile function is normal.
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F1
There was a small amount of pericardial effusion located around the posterior aspect of the heart (Figure 1).
Parasternal short axis view at the base of the heart during the acute phase, demonstrating (a) prominent left coronary artery and (b) a slightly 'echobright' right coronary artery.
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F2
Both the proximal left coronary artery (LCA) and the right coronary artery (RCA) appeared slightly echobright without any ectasia or aneurysm formation (Figures 2a and 2b).
Parasternal short axis view at follow-up, demonstrating normal left ventricular contractility and resolution of pericardial effusion.
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F3
The pericardial effusion had resolved (Figure 3).
Parasternal short axis view at the aortic annulus demonstrating giant aneurysms in the right coronary artery, left anterior descending artery, and another giant aneurysm posteriorly in the left circumflex artery region.
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F4
Apical four chamber view with anterior angulation demonstrating all three giant aneurysms. The right coronary aneurysm lies at the atrioventricular groove (AV) and the left sided aneurysms are noted along the interventricular septum and the left AV groove.
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F5
Still frame image showing the diameter of the right coronary artery aneurysm.
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F6
The aneurysm in the proximal left anterior descending artery (LAD) measured 9.5 mm (Figure 6) and the one in the proximal RCA measured 14mm (Figure 7).
Still frame image showing size of the coronary artery aneurysms of the left anterior descending artery and circumflex artery.
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F7
The aneurysm in the proximal left anterior descending artery (LAD) measured 9.5 mm (Figure 6) and the one in the proximal RCA measured 14mm (Figure 7).
Aneurysm in the region of the circumflex branch of left coronary artery with an area of increased echogenecity along the aneurysmal wall, suspicious of a thrombus.
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F8
An area of increased echogenecity was noted along the aneurysmal wall of left circumflex artery that was suspicious of a thrombus (Figure 8).
Selective left coronary artery angiogram in slight left anterior oblique view with caudal angulation. The left main coronary artery appears normal and trifurcates into the left anterior descending (LAD), ramus and circumflex branches. The giant aneurysm in the LAD appears globular in this view and is densely opacified. The ramus aneurysm is long and saccular, located inferior to LAD. There is ectasia of the circumflex branch.
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F9
The aneurysm of the LAD measured 19x10 mm (Figure 9).
AP view of the same demonstrating overlapping of ramus and LAD aneurysms.
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F10
This aneurysm had an irregular contour and the contrast lingered along the wall suggesting presence of a thrombus (Figure 10).
Straight lateral view of a selective right coronary artery angiogram demonstrating a giant aneurysm just distal to the coronary ostium. Multiple small aneurysms are noted throughout the course of the right coronary artery and posterior descending.
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F11
Selective RCA angiography revealed multiple saccular aneurysms throughout the course of the artery with the most proximal one being giant sized, measuring 14 mm (Figure 11).