Author + information
- Received November 3, 2009
- Accepted November 11, 2009
- Published online August 17, 2010.
A 70-year-old man with a history of myocardial infarction presented with increasing dyspnea. Chest radiography (A) showed a large right mediastinal mass. Cardiovascular magnetic resonance confirmed a mass in the atrioventricular groove (B, Online Video 1) compressing the right heart chambers. On magnetic resonance angiography, the superior aspect of the mass enhanced in the arterial phase (C, Online Video 2), in keeping with patent true lumen of a giant right coronary artery aneurysm secondary to chronic inferior infarction (D). This was confirmed by conventional angiography (E, Online Video 3). This was treated by surgical resection, and the patient is currently doing well. In summary, coronary artery aneurysms can mimic pericardial masses, and cardiac magnetic resonance is a useful noninvasive diagnostic modality. (A) Chest radiograph showing a right-sided mediastinal mass (*). (B) 4-chamber view; note the heterogeneous mass (*) in the right atrioventricular groove. (C) Coronal image after injection of gadolinium contrast. There is filling of the superior aspect of the mass (arrow) in conjunction with left ventricle enhancement (*). (D) Short-axis view depicting full thickness scar in the inferior/inferolateral wall (arrow) in keeping with right coronary artery territory infarction. (E) Coronary angiography showing aneurysm of the right coronary artery (*).
- Received November 3, 2009.
- Accepted November 11, 2009.
- American College of Cardiology Foundation