%0 Case Reports
%T Giant Coronary Arterial Aneurysm of the Proximal Left Anterior Descending Artery as the Cause of Wide Splitting of the Second Heart Sound.
%A Nagasawa A
%A Mori S
%A Akita T
%A Yamada H
%A Oki T
%A Nishii T
%A Yamashita T
%A Okita Y
%A Hirata KI
%J Intern Med
%V 57
%N 8
%D Apr 2018 15
%M 29269675
%F 1.282
%R 10.2169/internalmedicine.9708-17
%X Even in modern clinical cardiology, basic auscultation skill is not obsolete and is still important because it can always provide a clue to an underlying pathophysiology. We demonstrate an unusual mechanism of pathological wide splitting of the second heart sound due to external compression of the pulmonary trunk in a patient with a giant coronary arterial aneurysm of the proximal left anterior descending artery. Echocardiography, when combined with a three-dimensional anatomical analysis with cardiac computed tomography, was useful for elucidating the mechanism of the abnormal heart sounds.