Dissecting aneurysms of coronary arteries

Abstract

A case of dissecting aneurysms of coronary arteries caused by cardiac surgery was found. Review discloses that most coronary arteries arise spontaneously, occur more often in women than men, frequently in the postpartum period, and are characterized by the sudden onset of acute chest pain in a previously well middle aged patient who abruptly collapses and dies. The anterior descending branch of the left coronary artery is most frequently affected, the dissection usually involves the first portion of that single vessel, and the lesion appears amenable to bypass venous grafting. While the cause is unknown, the frequency of pregnancy, the loosening effect of that condition on connective tissue, and the occasional finding of medial degeneration of the arterial wall suggest cystic medial necrosis as an important etiologic consideration. This case report recommends gentle handling of coronary arteries in surgical procedures.