Giant coronary sinus aneurysm: an incidental discovery in a case of acute coronary syndrome.

Coronary sinus (CS) anomalies, although infrequent, are increasingly diagnosed with advances in interventional procedures and imaging techniques. Most cases are asymptomatic and incidentally diagnosed. We present a case of an elderly male without comorbidities who presented with acute angina. Coronary catheterisation revealed a double-vessel disease, but incidentally, sequential angiograms captured contrast filling in the levophase of CS, revealing a giant CS. Primary percutaneous angioplasty of the right coronary artery was performed successfully. Echocardiography confirmed the aneurysm, and a CT scan showed an aneurysmally dilated CS and other coronary veins alongside a normal-sized persistent left superior vena cava draining to the right atrium through CS. CS aneurysms may lead to complications such as thrombosis, embolic events, arrhythmias and heart failure, stressing the importance of vigilant monitoring and timely intervention. This case underscores the significance of recognising CS anomalies in cardiac procedures, even when asymptomatic, for proper management.

Takotsubo Cardiomyopathy in a Case of Intracerebral Hemorrhage: A Case Report.

Takotsubo cardiomyopathy may present like acute coronary syndrome and is characterized by reversible left ventricular (LV) apical ballooning in the absence of any significant underlying coronary artery disease. A 65-year-old lady presented to the ED with history of sudden onset left-sided weakness of body. Head CT scan was suggestive of right gangliocapsular intracerebral bleed with intraventricular extension. 2D Echo showed characteristic LV apical ballooning with hypokinesia and LV ejection fraction of 25%-30%. Diagnosing Takotsubo cardiomyopathy includes resolution in electrocardiogram (ECG) changes and reversible LV dysfunction on two-dimensional echocardiogram, and a normal coronary angiography.