EURORAD ESR

Case 14518

Aortitis as a cause of acute coronary syndrome

Author(s)
Emad Moussa FRCR/MD; Mohamed Andron MD, CCT (UK) FRCP; Ahmed Munir MD; Atheer Al-Ansari FRCP (UK)

Mediclinic Airport Hospital,
Abudhabi, UAE
memad@mediclinic.ae
 
Patient
female, 50 year(s)
 
 
  • Figure 1
    CT coronary angiography
     

    CT pre contrast with diffuse mural thickening and increased density of ascending aorta walls (arrows).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Delayed enhancement CT with diffuse swollen intima and enhanced media and adventitia (arrows).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Delayed enhancement CT coronal MPR of the ascending thoracic aorta with enhancement of the media and adventitia layers (arows).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    MIP CT with mural thickening of the aortic root, narrowed coronary ostia (back arows), normal aortic arch main branches (white arrowheads) and normal remainder of the aorta (white arrows).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    MPR of the left main coronary ostium with severe stenosis due to aortic wall thickening (arrow).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    CT MPR with RCA significant ostial stenosis due to aortic walls thickening (arrow).

     
    Area of Interest: Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 2
    Conventional coronary angiography
     

    Severe ostial stenosis of the LMA

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; Procedure: Angioplasty; Special Focus: Inflammation;

    Post LMA ostial stenting

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; Procedure: Angioplasty; Special Focus: Inflammation;

    Severe RCA ostial stenosis

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; Procedure: Angioplasty; Special Focus: Inflammation;

    RCA post ostial stenting

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; Procedure: Angioplasty; Special Focus: Inflammation;
     
     
CT pre contrast with diffuse mural thickening and increased density of ascending aorta walls (arrows).
 
Delayed enhancement CT with diffuse swollen intima and enhanced media and adventitia (arrows).
 
Delayed enhancement CT coronal MPR of the ascending thoracic aorta with enhancement of the media and adventitia layers (arows).
 
MIP CT with mural thickening of the aortic root, narrowed coronary ostia (back arows), normal aortic arch main branches (white arrowheads) and normal remainder of the aorta (white arrows).
 
MPR of the left main coronary ostium with severe stenosis due to aortic wall thickening (arrow).
 
CT MPR with RCA significant ostial stenosis due to aortic walls thickening (arrow).
 
Severe ostial stenosis of the LMA
 
Post LMA ostial stenting
 
Severe RCA ostial stenosis
 
RCA post ostial stenting
 
 
 
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