A Thrombotic Coronary Artery Aneurysm Associated with Atherosclerosis in a Patient with End Stage Renal Disease

Korean Journal of Nephrology 2011;30(3):329-334.

Yu Kyung Hyun, M.D.1, Se-Jung Yoon, M.D.2, Sang Hun Lee, M.D.1, In Tae Kim, M.D.1, Hyung Bok Park, M.D.1, Yoon Ji Kim, M.D.1 and Sang Choel Lee, M.D.1

Division of Nephrology¹
Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea, Division of Nephrology²
Department of Internal Medicine, NHIC Ilsan Hospital, Goyang, Korea

증례 : A Thrombotic Coronary Artery Aneurysm Associated with Atherosclerosis in a Patient with End Stage Renal Disease

Yu Kyung Hyun, M.D.1, Se-Jung Yoon, M.D.2, Sang Hun Lee, M.D.1, In Tae Kim, M.D.1, Hyung Bok Park, M.D.1, Yoon Ji Kim, M.D.1 and Sang Choel Lee, M.D.1

Division of Nephrology1, Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea, Division of Nephrology2, Department of Internal Medicine, NHIC Ilsan Hospital, Goyang, Korea

Abstract

We present a case of thrombotic coronary aneurysm of the left anterior descending artery (LAD) presenting with recurrent severe orthopnea in an end stage renal disease patient. She was admitted to the hospital with progressive dyspnea, exertional chest pain, and profound orthopnea. The echocardiography revealed a well marginated mass lesion between the main pulmonary artery and the left atrium. Chest CT showed a space-occupying lesion surrounded by the main pulmonary artery, the left atrium and the appendage adjacent to the atherosclerotic calcified lesion. Coronary angiography confirmed a huge thrombotic aneurysm with total occlusion of the proximal LAD. The presentation and management of the coronary aneurysm was reviewed.

Key Words: Coronary aneurysm, Renal dialysis, Atherosclerosis