An Aneurysm of the Left Main Coronary Artery in a Patient with Metabolic Syndrome

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In this paper we present an aneurysm of the left main coronary artery in a patient with metabolic syndrome.

A 68-year-old woman with prior history of hypertension, type 2 diabetes and dyslipidemia was presented at our hospital because of exertional dyspnea. On admission blood pressure was 145/80 mmHg, with a regular pulse of 78 bpm. Cardiovascular and other system examinations were entirely normal. The electrocardiogram showed sinus rhythm with no significant ST segment changes. The exercise treadmill stress test showed ST depression of 1.5 mm in leads V5-6. Coronary angiography revealed a giant aneurysm of the left main coronary artery with proximal ectasia of left anterior descending and circumflex artery (figure 1); the rest of the coronary tree was free of aneurysm and atherosclerosis. The patient was treated with aspirin, perindopril and atorvastatin.

Coronary artery aneurysm is a rare anomaly, which is described as the enlargement of coronary artery diameter to 1.5 times or more than its normal size. The incidence varies between 0.3% and 4.9% in different series. Most of the coronary artery aneurysms develop on the right coronary artery. Left main coronary artery aneurysms are extremely rare, and usually extend into the adjacent left anterior descending and circumflex artery proximal segments. Most of the cases are associated with atherosclerosis and Kawasaki disease. Coronary artery aneurysms should be treated according to existence of concomitant coronary artery disease. Patients with no obstructive coronary artery disease are recommended to be managed medically, while coronary bypasses should be performed when indicated by the severity of stenosis or progressive angina despite medical therapy.

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Additional Info

  • Recieved: 28.05.2012
  • Accepted: 16.06.2012
  • Published Online: 16.06.2012
  • Printed: 01.03.2014
  • DOI: 10.4328/JCAM.1113
  • Author: Muhammet Rasit Sayin, Ibrahim Akpinar, Turgut Karabag
  • Identifier: J Clin Anal Med. 2014;5(2):173-173
  • Index Page: 173-173
  • How to Cite: Muhammet Rasit Sayin, Ibrahim Akpinar, Turgut Karabag. An Aneurysm of the Left Main Coronary Artery in a Patient with Metabolic Syndrome. J Clin Anal Med. 2014;5(2):173-173
  • Running Title: An Aneurysm of the Left Main Coronary Artery
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