Chest
Clinical InvestigationsCoronary Artery Aneurysm: A Review of the Literature with a Report of 11 New Cases
Section snippets
Methods
The clinical features and the angiographic and hemodynamic findings were evaluated in 11 patients with aneurysms of the coronary arteries. All patients included in this prospective study were part of a larger series of patients (742) who had been referred for cardiac catheterization and coronary arteriographic studies from July 1, 1973 through April 1, 1975. Informed consent was obtained from all patients. Catheterization was performed with patients in the fasting state, under mild sedation
Clinical History
Clinical data are presented in Table 1. The ages of the patients (ten men and one woman) ranged from 35 through 69 years. The duration of symptoms ranged from one month to 14 years. Eight of the 11 patients had unstable angina pectoris; and in two patients the pattern of angina, although not changing, was refractory to medical therapy. All patients had classic histories of angina pectoris; and in five patients, there were clear histories of previous myocardial infarction documented both by
Incidence
The incidence of coronary artery aneurysms has been reported at 0.3 percent during life26 and 1.4 percent at death (from a review of 644 consecutive autopsies5). In the present study the 11 cases were recognized from a larger group of 742 cases, a percentage of 1.5. Previously, this condition was thought to be extremely rare. But as demonstrated by Table 2, only six cases were recognized before 1970, and 28 cases since 1970. The rate of recognition probably parallels the increased use of
Acknowledgment
We wish to acknowledge the technical assistance of Mr. James A. Cramer and Mr. Rick A. Lenth in the preparation of this manuscript.
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Supported in part by grants from the Iowa Heart Association and the Veterans Administration, and by National Institutes of Health grant HL 014388.
Manuscript received October 3; revision accepted November 21.