087H RCA aneurysm in young female

36F with RCA aneurysm iagnosed while pregnant. Seen in congenital clinic

31F RCA aneurysm post congenital fistula post repair Note calcification right heart border
31F RCA aneurysm post congenital fistula post repair Note substernal cuevilinear calcification
Ashley Davidoff thecommonvein.net

Remote RCA fistula closure (Jacksonville, FL) AngioCTCAhere with no coroanry athero; R dominant coronary circulation with normal origin. Large proximal RCA aneurysm (3.5 cm) involving ostium and spanniong 5 cnm in length. Mural thrombus within aneiurysmal sacand peripheral Ca+. Mid-distal RCA without stenosis in the RCA

 

CT 2016

HISTORY:
37 year old woman with history of coronary artery fisula, status post
repair as a child, now with a right coronary artery aneurysm, who
presents for follow up.

1. Large proximal right coronary artery aneurysm involving the ostium that measures up to 3.5 cm in diameter. Comparison with outside imaging is recommended to determine stability.

31F RCA aneurysm post congenital fistula post repair from 6 years ago Note right sinus without distortion
 thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note max transverse dimension in the coronal projection is 3.7cms
thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note max transverse dimension in the coronal projection is 3.7cms
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note orthogonal views in sagittal and coronal projection 
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note RAO view of the aneurysm and distal RCA –  6.2 cms x 3.8 cms LAO 23 degrees – caudal 20 degrees
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note 3D view of the LAD and circumflex i likely co- dominant system
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note 3D view of the LAD and circumflex i likely co- dominant system
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note distal RCA is patent and supplies the PDA – likely co- dominant system
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 2 years ago Note straight MPR view of the aneurysm and distal RCA
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 6 years ago Note RAO view of the aneurysm and distal RCA –  6.2 cms x 3.8 cms LAO 23 degrees – caudal 20 degrees
Ashley Davidoff thecommonvein.net

 

Latent TB

2 years ago Large proximal RCA coroanry aneurysm (3/5 cm) involving ostium and spanning 5 cm in length. Mural thrombus with aneurysmal sac and peripheral Ca++, mid-distakl RCA without stenosis I nthe RCA.

CV IMAGING: TTE (1 year ago ): LVEF 50% with Gr 1 Ddysfn Mild incr. LV wall thickness. LA/RV/RA NL. Aov and Miv OK. PV/TV NL. Ao root OK .3×3 cm round vascular lesion outside RA corresponding to the RCa aneurysm There is no IA shunt by color doppler.
UPDATE CCTA: (2 years ago  ); LCA NL; LAD NL warpas around the LV apex; 2 diagonals OK ;LCX andand OMLCX OK ;RCA: ANEURYSM involving the ositium/cusp extendiong into the proximal RCAegment. 5.1×4.0x4.4 cm in current exam siht large eccentric mural thrombus and peripheral Ca++; contrast opacidified lumen 3.0×3.3 x3,3 cm and RCa ostium measuring 2.4×2,,5 cm, Mid-dstal RCa without athero or luminal narrowing. RPL and RPDA originating from RCA. Normal Aov and Miv. Normal pericardium. Normal visualized aorta. Borderline enlarged main PA @ 30 Mm./ NO CHANGES IN SIZE OF RCA ANEURYSM as comaped to study of 3 years ago

2 years ago

31-year-old female with history of RCA aneurysm since 6 years ago s/p
surgical correction of coronary AV fistula with known RCA aneurysm.

2.The The RCA aneurysm measures 5.1 x 4.0 x 4.4 cm in the current
exam and demonstrates a large eccentric mural thrombus and peripheral
calcifications, with the opacified lumen measuring 3.0 x 3.3 x 3.3
cm. There is no change in the size of the aneurysm since the prior
study of 2018
3.No significant coronary artery plaque or stenosis, except for
location of RCA aneurysm.

31F RCA aneurysm post congenital fistula post repair – CT from 2 years ago Note distal RCA is patent and supplies the PDA – likely co- dominant system
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair – CT from 2 years ago Note distal RCA is patent and supplies the PDA – likely co- dominant system The aneurysm in the axial projection measures 5.2cms x 4cms
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 2 2years ago Note 3D view of the LAD and circumflex likely co- dominant system
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 2 2years ago Note 3D view of the lumen of the RCA aneurysm
Ashley Davidoff thecommonvein.net
31F RCA aneurysm post congenital fistula post repair from 2 years ago Note RAO view of the aneurysm and distal RCA –  6.1cms x 4.3cms LAO 23 degrees – caudal 20 degrees
Ashley Davidoff thecommonvein.net

 

cURRENT

Complaint: 42 yo f. Phamacy Techniician
Ff: 1) Remote RCA fistula (Jacksonville, FL); CCTA here with no coconary atherosclerosis. Right domimnant coronary artery. LARGE PROXIMAL RCA CORONARY ANEURYSM (3.5cm , involving RCA Ostium and spanning 5 cm in length; MURAL THROMBUS within the aneurysmal sac. And, peripheral Ca++ mid to distal RCA without stneosis.

CV IMAGING: TTE (3 YEARS AGO ): LVEF 50% with Gr 1 ddysfn.normal chamber size. LA/RV/RA NL. Aortic root 3×3 cm round. Vascular lesion outsie RA correspopnding to RCA aneurysm. No interatrial shunt on color doppler.

UPDATE CCTA (2 YEARS AGO ): LCA NL. LAD wraps aroud LV Apex;and 2 diagonal branches, all OK;RCA ANEURYSM involving OSTIUM, extending into proxiomal RCA (5.1×4.0x4.4 cm with large indwelling eccentric mural thrombus and peripheral Ca++ ; contrast opacified lumen: (3.0×3.3×3.3 cm) without atherosclerosis or luminal narrowing; RPL and RPDA originating from RCA. Normal AoV and MiV and visualized ascending aorta. And pulmonary artery. NO CHANGE IN SIZE of RCA ANEURYSM compared to CCTA of 2018.