Ruptured coronary artery aneurysm mimicking as a giant mediastinal mass

A 49-year-old male with chest discomfort and suspected mediastinal mass (Panel A, pentagram) was transferred to our unit. Medical history was notable for hypertension, and work-up for vasculitis and connective tissue disorders was unremarkable. Computed tomography angiography (CTA) revealed a large heterogeneous mass (85  mm × 52 mm) locating between the aorta and pulmonary artery, and a giant right coronary artery aneurysm (CAA; 29 mm × 19 mm, asterisk) was entrapped in this mass (Panels B andC). Further coronary angiography (Panel D) confirmed the diagnosis of a right CAA, and no additional coronary anomalies were observed. Transoesophageal echocardiography (Panel E; Supplementary material online, Video S1Supplementary material online,Video S1) demonstrated a circumscribed anechoic cavity adjacent to the right cardiac chambers.
Source: European Heart Journal - Category: Cardiology Source Type: research