Coronary Aneurysms in a Young Woman: Angiographic Documentation of the Natural Course

A 19-year-old woman is reported with saccular aneurysms of the left anterior descending coronary artery and of diagonal branches. A scratchy systolic-diastolic murmur, heard on several occasions, gave the clinical impression that one of the aneurysms was in the process of rupturing. The patient's condition, however, remained stable until she developed an acute myocardial infarction. Postinfarction coronary arteriography showed complete occlusion of the anterior descending artery, most likely caused by thrombosis in one of the aneurysms which extended into the coronary artery.