Proximal Left Main Coronary Artery Aneurysm Presenting as ST-Elevation Myocardial Infarction Treated by Stenting

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Coronary artery aneurysm (CAA) is a rare cardiac anomaly, defined by a coronary artery diameter exceeding 1.5 times the reference diameter.
• Causes include congenital factors, atherosclerosis in adults, and Kawasaki disease in children.
• The Right Coronary Artery is the most commonly affected vessel; left main coronary artery aneurysms are exceptionally rare.

Observation:

• A 49-year-old male presented with ST-Elevation Myocardial Infarction (STEMI).
• Initial angiography revealed Left Anterior Descending (LAD) stent thrombosis, followed by spontaneous recanalization.
• A subsequent angiography identified a large left main coronary artery aneurysm (9.8 mm maximum diameter).

Findings:

• The study reports a rare case of a large left main coronary artery aneurysm.
• The aneurysm was diagnosed using coronary angiography, the gold standard for diagnosis and treatment.
• The patient's STEMI was initially attributed to LAD stent thrombosis, with spontaneous recanalization observed.

Implications:

• This case underscores the importance of considering rare etiologies like left main coronary artery aneurysms in patients with myocardial infarction.
• Successful treatment with a coronary stent demonstrates a viable therapeutic option for this rare condition.
• Further research into the management and long-term outcomes of left main coronary artery aneurysms is warranted.