Aneurisma de arteria coronaria. Informe de un caso

Abstract

Several decades have elapsed since the first aneurysm of the coronary artery were described, anatomopathologically at the beginning and angiographically later on, but we are still devoid of data which may orient us towards their presence when they turn to be anatomopathological or angiographic findings. This is the case of a sixteen years old girl who was admitted to our coronary unit with an acute myocardial infarct (AMI) of the left ventricle in its inferior-lateral wall, with a typical clinical, electrocardiographic and enzimologic evolution. This leads us to a diagnosis of AMI, not caused by atherosclerosis coronary disease. The clinical non atherosclerotic characteristics of AMI, are the following: low incidence of presentation; occurring at an average earlier age; more frequent in men; with almost total absence of prodrome and cardiovascular risk factors such as smoking and oral contraceptives and the good evolution in the acute late stage with roles out a previous myocardiopathy. Coronary angiography made fifty days later resulted in a diagnosis of aneurysm on the proximal segment of the right coronary artery, with no occlusion of the lumen of the vessel. In the absence of evidences that may suggest another diagnosis, this is considered congenital with a thrombosis causing the transmural AMI with a posterior thrombolisis and repermeabilization of the lumen.