A Case Study of Chronic Coronary Syndrome Revealing a Proximal Left Anterior Descending Artery Aneurysm
En-Nasery Amal
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
Boucetta Abdellah *
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
Obeida Saleh
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
Altimimi Alaa
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
Maha BOUZIANE
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
Meriem HABOUB
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
Rachida Habbal
Cardiology Department, CHU Ibn Rochd Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Context: Coronary artery aneurysms (CAA) are rare entities associated with significant clinical consequences, including thrombotic occlusions. Chronic coronary syndrome (CCS) may reveal CAA, complicating patient management, particularly when associated with coronary thrombosis. This case discusses a 55-year-old male presenting with angina and dyspnea, later found to have a proximal left anterior descending artery (LAD) aneurysm with thrombotic occlusion.
Case Presentation: A 55-year-old male with a history of hypertension, diabetes, and hyperlipidemia presented with exertional chest pain and dyspnea over three months. Coronary angiography revealed a large proximal LAD aneurysm with thrombotic occlusion of the mid-LAD (type B1).
Initial management included thromboaspiration and stent placement, followed by dual antiplatelet therapy (DAPT). Despite recanalization, the patient developed a no-reflow phenomenon, managed with vasodilators and anticoagulation.
Conclusion: CAA can complicate the course of coronary syndromes, especially when associated with thrombosis. Percutaneous intervention can be successful, but complications like reocclusion and no-reflow may require intensive management strategies.
Keywords: Chronic coronary syndrome, proximal left anterior descending artery aneurysm, a case study, literature review