Giant right coronary artery aneurysm presenting with recurrent syncope: A diagnostic challenge

Coronary artery aneurysm (CAA) is a rare form of coronary artery disease characterized by abnormal dilation of a coronary artery segment. While CAAs can present with various symptoms, syncope is notably uncommon, with limited documented cases. We present the case of a 24-year-old woman with a 2-month history of recurrent syncope, occurring in the absence of other symptoms. Initial evaluations, including MRI and cardiac examinations, revealed no abnormalities. However, a transthoracic echocardiogram identified a ring-like structure adjacent to the tricuspid valve, and subsequent computed tomography angiography confirmed a large right coronary artery aneurysm. This case highlights the rare presentation of recurrent syncope as a manifestation of CAA, emphasizing the need for timely diagnosis and intervention in similar cases.