Images in cardiovascular medicine. Spontaneous rupture of the right coronary artery.

We report on a case of spontaneous coronary artery rupture in a 65-year-old woman. In this patient, pulmonary hypertension had been known for 12 years. The patient was receiving long-term oxygen treatment, oral anticoagulation, and sildenafil. Coronary heart disease had been excluded by coronary angiography 2 years before the event, and only dilated coronary arteries with arteriosclerotic plaques but no stenosis were described. On admission to our clinic, she presented with symptoms of progressive dyspnea resulting in a New York Heart Association functional class III–IV. Electrocardiography changes, especially signs of myocardial infarction, were not visible (see Figure 1). Lab tests, including serum troponin, showed no abnormalities. Figure 1. Electrocardiogram showed a sinus rhythm with a heart rate of 62 bpm, no signs …