Simultaneous presentation of giant aneurysms of the coronary sinus and superior vena cava

Y Cheng,Y Mou,H Gao,Z Zheng

doi:10.5830/cvja-2016-031

Abstract

Aneurysms of the coronary sinus and superior vena cava are rare and their aetiologies remain controversial. Some studies have shown that these acquired venous aneurysms are caused by an increase in right atrial pressure, which may be related to right heart failure. However, few reports have provided direct evidence to support this hypothesis. We present a rare case of combined giant aneurysms of the coronary sinus and vena cava, diagnosed using multiple imaging modalities. This case strongly supports the hypothesis that right heart diastolic failure may be an important mechanism underlying the pathogenesis of combined giant aneurysms.

Highlights

Case reportA 22-year-old woman was referred to our hospital because of a large mass in the left thorax, detected on chest X-ray
Aneurysms of the coronary sinus and superior vena cava are rare and their aetiologies remain controversial
We present a rare case of combined giant aneurysms of the coronary sinus and vena cava, diagnosed using multiple imaging modalities

Summary

Case report

A 22-year-old woman was referred to our hospital because of a large mass in the left thorax, detected on chest X-ray. A physical examination revealed severe facial and lower-extremity oedema, hepatomegaly and ascites She had no cardiac murmur and no cyanosis, with an oxygen saturation of 96.6% on room air. Transthoracic echocardiography showed an enlarged right atrium and a huge cavity behind the left heart (Fig. 1A). Tissue Doppler imaging (TDI) velocities at the septal mitral annulus showed that early diastolic myocardial velocity (e′) and systolic myocardial velocity (s′) were 5.85 and 10.4 cm/s, respectively (Fig. 1B). Septal mitral annulus e′ and s′ velocity were 6.54 and 19.5 cm/s, respectively (Fig. 4A) These features suggested that the patient had had a long history of right heart diastolic failure, and this may have contributed to the progression of the combined giant aneurysms

RV AO

Discussion

IVS CSA

Conclusion