Dissecting Aneurysms of the Coronary Arteries

This paper reports two cases of coronary dissecting aneurysms of the heart. These were found among 45 consecutive autopsy cases with cardiac diseases from January, 1978 to April, 1981. The first case, a 60-year-old woman, revealed dissecting aneurysm involving the aorta and three main coronary arteries in association with cystic medial necrosis. The second case, a 55-year-old man, revealed dissecting hematoma limited to the right coronary artery without any presumptive causal lesion to the dissection. The dissections could not be identified by either clinically or even macroscopic examinations of the autopsy materials. It is likely that the dissecting coronary aneurysm is not so uncommon nor fatal lesion as previously thought. Considerable number of the cases would be concealed in those of sudden death not autopsied or carelessly autopsied, or in those survived myocardial infarction not angiographied.