case_images: PMC2646726_01
case_images: Arteriographic and echocardiography findings. (A) Selective visceral arteriogram demonstrating calibre variation and fusiform dilatation of the inferior mesenteric artery (arrows). (B) Echocardiogram on day 34 demonstrated multiple large coronary artery aneurysms including a 7 mm aneurysm affecting the proximal right coronary artery (arrowed). (C) Formal coronary digital subtraction arteriography 9 months after disease onset demonstrating minor ectasia of the left main coronary artery (LCA) and proximal circumflex (Circ. a, arrowed) and proximal left anterior descending artery (LAD, arrowed). This is most noticeable on the LAD just at the origin of the diagonal artery (Diagonal a, arrowed). The right coronary artery was of a normal caliber (not shown).
case_images: 1546-0096-7-3-1.jpg
case_images: PMC2646726_01_1546-0096-7-3-1.jpg
case_images: F1
case_images: Repeat echocardiography confirmed the severe CAA previously documented and selective visceral arteriography revealed pathological calibre variation of the inferior mesenteric artery (Figure 1A) compatible with medium sized mesenteric artery vasculitis. A repeat echocardiogram now showed deterioration in the CAL with overall RCA dilation of 5.4 mm and with a proximal RCA aneurysm of 7 mm (Figure 1B); left main coronary artery dilation of 6.7 mm and left anterior descending artery dilation of 5.9 mm with a distal aneurysm at 6 mm. The right coronary artery was of a normal caliber (Figure 1C).