ISSN: 2044-9038 (Print) 2044-9046 (Electronic)

Clinical Practice

Coronary Artery Aneurysm Impact Factor

 Coronary artery aneurysms were found in 16 men between 37 and 62 years aged, mean 51 years. Aneurysms were of two types: saccular and fusiform. They involved the proper arteria coronaria in 13 (87 per cent), the artery in eight (50 per cent) and therefore the left anterior descending artery in five (31 per cent). In some patients, quite one vessel was involved. Twelve patients presented with angina pectoris, three with congestive heart failure and one with both. Five were in functional class II, eight were in school III and three were in school IV at the start of the study. The electrocardiogram showed evidence of previous myocardial infarct in four patients; four patients had left ventricular hypertrophy, one had left axis deviation, one had left bundle branch block, one had right bundle branch block, two had degree heart block and 7 had abnormalities within the S-T segment and T wave. Obstructive coronary disease was present in all; the obstruction score was from 1 to 4 in three patients, from 5 to 9 in four patients and from 10 to 14 in the remaining nine. Similar aneurysms were found in the pulmonary artery of one patient and in the abdominal aorta of three patients; in seven of 14 patients with adequate venous angiograms, varicosities of the coronary venous tree were observed. Left ventricular dysfunction and angina pectoris were noted in patients with significant obstructive coronary disease (greater than 70 per cent) and also in patients without obstruction but with coronary aneurysms. Ten patients were treated surgically; nine underwent aortocoronary bypass and one mitral valve replacement. Criteria for bypass was the presence of obstructive disease and medically unresponsive angina pectoris. All but one surgically treated patient showed improvement. The functional class in medically treated patients was unchanged. Fourteen patients were still alive at the completion of the study.

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