This case highlights that multiple atherosclerotic coronary aneurysms can lead to acute myocardial infarction, likely through the mechanism of coronary embolization.
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Coronary aneurysms may cause AMI via embolization; single case report leaves open whether screening or therapy alters outcomes.
A 60-year-old woman with multiple coronary aneurysms, complicated with acute infero-posterior myocardial infarction is presented. The cine-coronary arteriogram disclosed a diffuse dilatation of epicardial coronary arteries associated with multiple aneurysms, fusiform ones in the right coronary and the left circumflex coronary arteries and saccular ones in the left anterior descending coronary artery. Distal run-off was poor. Ventriculography revealed a decrease in the ejection fraction (36%) and segmental abnormal wall motion at the apical and infero-posterior regions. The cause of the aneurysms appeared to be atherosclerotic. We suggested that coronary embolization was the cause of acute myocardial infarction in this case.
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Makino et al. (1982) studied this question.
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