Giant Coronary-Artery Aneurysm

This image-based case report describes a 79-year-old woman referred for cardiovascular evaluation due to a gradually enlarging radiographic abnormality along the left cardiac border, initially noted six years prior. Despite the absence of symptoms and a normal cardiac exam, serial chest radiographs revealed progressive enlargement. Coronary CT identified a 45 mm aneurysm arising from the left coronary artery, consistent with a diagnosis of a giant coronary-artery aneurysm (>20 mm). Cardiac catheterization revealed blood flow from the left coronary artery into the aneurysm and into the pulmonary artery via a fistula. The patient underwent successful surgical ligation and plication of the aneurysm and fistula closure. Although giant coronary-artery aneurysms may be asymptomatic and incidentally detected, they pose risks including thrombosis, embolization, and rupture, and are commonly managed surgically. The patient recovered well and was discharged 16 days postoperatively.

This image-based case report describes a 79-year-old woman referred for cardiovascular evaluation due to a gradually enlarging radiographic abnormality along the left cardiac border, initially noted six years prior. Despite the absence of symptoms and a normal cardiac exam, serial chest radiographs revealed progressive enlargement. Coronary CT identified a 45 mm aneurysm arising from the left coronary artery, consistent with a diagnosis of a giant coronary-artery aneurysm (>20 mm). Cardiac catheterization revealed blood flow from the left coronary artery into the aneurysm and into the pulmonary artery via a fistula. The patient underwent successful surgical ligation and plication of the aneurysm and fistula closure. Although giant coronary-artery aneurysms may be asymptomatic and incidentally detected, they pose risks including thrombosis, embolization, and rupture, and are commonly managed surgically. The patient recovered well and was discharged 16 days postoperatively.