Author Credentials

Obadah Aqtash MD Ahmed Amro MD Bilal Alam MD Amal Sobeih MD Melissa Lester DO Rameez Sayyed MD




Coronary Artery Aneurysm (CAA) is defined as a dilation of more than 1.5 times normal in a segment of the coronary artery. While the incidence of CAA is highest in the Right Coronary Artery (RCA), it is agreed that left main coronary artery or three-vessel involvement is extremely rare. Wide ranges of factors have been implicated in the cause of CAA with atherosclerosis being the most common at 50%. Congenital CAA occurs in 20-30% of cases followed by connective tissue disease at 10%. Blood stagnation and exposure of the underlying collagen make aneurysms prone to thrombosis, dissection, and vasospasm. Depending on the size, symptoms, and etiology of the aneurysms; a surgical, percutaneous, or medical approach may be used. In this paper, we are presenting a patient who presented to the emergency department (ED) with chest pain due to Acute Coronary Syndrome (ACS) that was found to be due to multi-vessels CAAs involving the left main as well as RCA, Left Anterior Descending (LAD) artery and Left Circumflex Artery (LCA) requiring urgent Coronary Artery Bypass Grafting (CABG).

Conflict(s) of Interest


References with DOI

1. Cohen P, O'Gara PT. Coronary artery aneurysms: a review of the natural history, pathophysiology, and management. Cardiol Rev. 2008;16(6):301-4. https://doi.org/10.1097/crd.0b013e3181852659

2. Halapas A et al. Giant right coronary artery aneurysm in an adult male patient with non-ST myocardial infarction. Hellenic J Cardiol. 2013;54(1):69-76.

3. Villines TC, Avedissian LS, Elgin EE. Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review. Cardiol Rev. 2005;13(6):309-11. https://doi.org/10.1097/01.crd.0000159579.77038.dc

4. Zeb M et al. Treatment of coronary aneurysms with covered stents: a review with illustrated case. J Invasive Cardiol. 2012;24(9):465-9.

5. Nichols L, Lagana S, Parwani A. Coronary artery aneurysm: a review and hypothesis regarding etiology. Arch Pathol Lab Med. 2008;132(5):823-8.

6. Diaz-Zamudio M et al. Coronary artery aneurysms and ectasia: role of coronary CT angiography. Radiographics. 2009;29(7):1939-54.

7. Williams MJ, Stewart RA. Coronary artery ectasia: local pathology or diffuse disease? Cathet Cardiovasc Diagn. 1994;33(2):116-9. https://doi.org/10.1002/ccd.1810330206

8. Luscher TF et al. Endothelium-derived relaxing and contracting factors: perspectives in nephrology. Kidney Int. 1991;39(4):575-90.

9. Sorrell VL, Davis MJ, Bove AA. Current knowledge and significance of coronary artery ectasia: a chronologic review of the literature, recommendations for treatment, possible etiologies, and future considerations. Clin Cardiol. 1998;21(3):157-60. https://doi.org/10.1002/clc.4960210304

10. Yang EH et al. Coronary and intracerebral arterial aneurysms in a young adult with acute coronary syndrome. Tex Heart Inst J. 2012;39(3):380-3.

11. Everett JE, Burkhart HM. Coronary artery aneurysm: case report. J Cardiothorac Surg. 2008;3:1.

12. Singh SK et al. Surgical treatment for coronary artery aneurysm: a single-centre experience. Interact Cardiovasc Thorac Surg. 2013;17(4):632-6. https://doi.org/10.1093/icvts/ivt282

13. Li D et al. Surgical treatment of giant coronary artery aneurysm. J Thorac Cardiovasc Surg. 2005;130(3):817-21.

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