Coronary artery aneurysm - A complication of post percutaneous coronary interventions and strategies for management
Journal Title: Medpulse International Journal of Medicine - Year 2019, Vol 9, Issue 1
Abstract
A 54 years married female patient was presented with chest pain and dyspnea on exertion. She was known case of hypertension and type 2 Diabetes mellitus she was asympatientsomaic until she develops chest pain and dyspnea on exertion for last 2 days associated with sweating. On physical examination general conditions are normal with normal cardiac examination. Her electrocardiogram showed normal sinus rhythm and normal axis with T wave inversion in leads v4-v6, cardiac enzymes showed raised CPKMB and TROPONIN. On 2D-ECHO examination she had apicolateral regional wall abnormality with ejection fraction of 45% and diastolic dysfunction. patients underwent coronary angiography which revealed left anterior descending artery (LAD) 80% stenosis and left circumflex artery 99% stenosis ,she had successful percutaneous coronary intervention with sirolimus eluting stent to left anterior descending artery (LAD) and left circumflex artery done on 01/09/2016.she was discharged on double antiplatelets and high dose statins and was regularly followed up with control of blood pressure and diabetic. After 3 month on, patients came with chest pain and dyspnea on exertion which were not relieved with oral medications, so patients was hospitalised again and check coronary angiography was done which shows patent stent in left anterior descending artery (LAD). the left circumflex artery stent showed in-stent restenosis with pseudoaneurysm formation. This was again confirmed on CT- CORONARY ANGIOGRAM. on 23/01/2017 coiling to left circumflex artery aneurysm was done with progreat. Patients stabilised hemodynamically and sympatientsomatically. Follow up check coronary angiography done on 25/04/2014 which revealed patent stents and disappearance of aneurysmal swelling. There is no clear mechanism responsible for the occurrence of coronary artery aneurysms occurring after drug-eluting stent implantation, and hence the treatment strategy remains controversial. The cause and treatment of this complication are PTCA with DES is discussed. Here we give emphasis on cause and treatment of aneurysm.
Authors and Affiliations
Vaibhav A Patil, G R Kane, Rohit Kumar, Somnath M
Keywords
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- EP ID EP517476
- DOI 10.26611/1021917
- Views 61
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