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An acute coronary syndrome in a patient with left main coronary aneurysm

Willibaldo Ojeda1, Jose Martinez-Toro

  • 1Section of Cardiology, Department of Internal Medicine, University of Puerto Rico School of Medicine.

Boletin De La Asociacion Medica De Puerto Rico
|July 21, 2009
PubMed

Insights

Left main coronary artery aneurysms are rare, affecting 0.1% of angiograms. This case highlights a complex aneurysm with severe artery obstruction, successfully treated with bypass surgery.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Aneurysms of the left main coronary artery (LMCA) are exceptionally rare, identified in approximately 0.1% of diagnostic angiograms.
  • LMCA aneurysms can lead to significant cardiovascular complications due to their location and potential for obstruction.

Observation:

  • A middle-aged male presented with a diagnosed left main coronary artery aneurysm.
  • The aneurysm was associated with severe ostial obstruction of the left anterior descending artery, a ramus branch, and the left circumflex artery.

Findings:

  • The etiology of the LMCA aneurysm was uncertain, with potential links to Kawasaki disease or cocaine toxicity.
  • The patient experienced acute coronary syndrome, necessitating surgical intervention.

Implications:

  • Successful coronary artery bypass grafting (CABG) was performed, resolving the acute coronary syndrome.
  • This case underscores the importance of considering rare etiologies and managing complex LMCA aneurysms aggressively to prevent adverse cardiac events.

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