2-1. Case History and Examination
An 82-year-old woman with hypertension visited our hospital with
abnormal electrocardiogram findings during a regular medical check-up.
Although the patient was asymptomatic, detailed tests were scheduled for
suspected ischemic heart disease.
She had undergone Halsted radical mastectomy for left breast cancer at
the age of 32 years and cholecystectomy for cholelithiasis at the age of
53 years.
She had no history of infectious diseases, such as syphilis,
tuberculosis, or infectious endocarditis, and no history of trauma or
inflammatory diseases such as aortitis.
Electrocardiography revealed a heart rate of 50/min, regular sinus
rhythm, non-specific QS complexes in V1,2, and ST
depression in V4,5,6.
Further, echocardiography revealed a left SVA. No asynergy was observed,
the ejection fraction was 73%, and moderate aortic regurgitation was
observed.
Computed tomography (CT) angiography confirmed the presence of a
saccular left SVA measuring 50 × 48 × 45 mm. A small mural thrombus was
observed in the aneurysm (Figure 1). Furthermore, extrinsic compression
of the left anterior descending artery was observed, and approximately
50% stenosis was noted (Figure 2).