American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Case Reports. 2020, 8(6), 150-152
DOI: 10.12691/ajmcr-8-6-4
Open AccessCase Report

Left Main Coronary Aneurysm: A Rare but a Serious Cause of Acute Myocardial Infarction

Mohammad Alhamaydeh1, , Daniel Ortolano1, David Bassilly1 and Amanpreet Sherwal1

1Conemaugh Memorial Medical Center, Internal Medicine Department, Johnstown, PA

Pub. Date: April 05, 2020

Cite this paper:
Mohammad Alhamaydeh, Daniel Ortolano, David Bassilly and Amanpreet Sherwal. Left Main Coronary Aneurysm: A Rare but a Serious Cause of Acute Myocardial Infarction. American Journal of Medical Case Reports. 2020; 8(6):150-152. doi: 10.12691/ajmcr-8-6-4


Left main coronary artery (LMCA) aneurysms are rare with incidence of 1 in 1000 cases among patients undergoing coronary angiography. Coronary artery aneurysm is defined as coronary arterial segment dilation > 1.5 fold greater than normal adjacent coronary segments. Atherosclerosis is the primary cause of coronary aneurysms but also has been reported in other conditions like arterial vasculitis (e.g., Kawasaki disease, Takayasu arteritis), or infection (e.g., syphilis, mycosis). LMCA aneurysms are especially associated with serious complications including thrombosis, distal embolization, spontaneous rupture or dissection or even sudden cardiac death. The optimal treatment for LMCA aneurysm is still controversial and the available results have been based mainly on case reports and not on controlled trials. The lack of consensus about managing LMCA is not the only challenge here. The lack of individualized treatment or precision medicine in this area makes managing these cases at bedside even more challenging.

left main coronary artery aneurysm myocardial infraction

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Topaz O, Rutherford MS, Mackey-Bojack S, Prinz AW, Katta S, Salter D, et al. Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates. Cardiovasc athol (2005) 14: 298-302.
[2]  Packard M, Wechsler HF. Aneurysms of coronary arteries. Arch Intern Med (1929) 43: 1-14.
[3]  Tunick PA, Slater J, Pasternack P, Kronzon I. Coronary artery aneurysms: a transesophageal echocardiographic study. Am Heart J (1989) 118(1): 176-9.
[4]  Lanjewar CP, Sharma A, Sheth T. IVUS-guided management of late stent malaposition with peri-stent restenosis with coronary artery aneurysm following drug-eluting stent implantation (paxlitaxel-eluting stent). J Invasive Cardiol (2009) 21:E87-90.
[5]  Lima B, Verma SK, Lowee JL. Nonsurgical management of left main coronary artery aneurysm. Tex Heart Inst J. 2006; 33: 376-79.
[6]  Williams MJ, Stewart RA. Coronary artery ectasia: local pathology or diffuse disease? Cathet Cardiovasc Diagn. 1994; 33: 116-119.
[7]  Robinson FC. Aneurysms of the coronary arteries. Am Heart J. 1985; 109: 129-135.
[8]  Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation (1983) 67(1): 134-8.
[9]  Doustkami H, Maleki N, Tavosi Z. Left main coronary artery aneurysm. J Tehran Heart Cent (2016) 11(1):41-5.
[10]  Villines TC, Avedissian LS, Elgin EE. Diffuse non-atherosclerotic coronary aneurysms. Cardiol Rev (2005) 13: 309-11.
[11]  Manginas A, Cokkinos DV. Coronary artery ectasias: imaging, functional assessment and clinical implications. Eur Heart J (2006) 27(9): 1026-31.
[12]  Karabulut A, Tanriverdi S. Progression of a small eccentric aneurysm to spontaneous coronary dissection within the left main coronary artery. Kardiol Pol. 2010; 68: 1404-1406.
[13]  Tiz√≥n-Marcos H, Bagur R, Bilodeau S. Left main mycotic aneurysm causing myocardial infarction. Can J Cardiol. 2010; 26: e276-e277.
[14]  Demopoulos VP, Olympios CD, Fakiolas CN, Pissimissis EG, Economides NM, Adamopoulou E, Foussas SG, Cokkinos DV. The natural history of aneurysmal coronary artery disease. Heart. 1997; 78: 136-141.
[15]  Nakayama Y, Shikawa A, Ayusawa Y, et al. Surgical repair of complicated coronary arteriovenous fistula and coronary artery aneurysm in an elderly patient after 26 years of conservative therapy. Heart Vessels. 2011; 26: 111-116.
[16]  Eltahawy EA, Colyer WR., Jr Left main coronary artery aneurysm and associated left anterior descending coronary artery stenosis treated with a stent graft. J Invasive Cardiol. 2009; 21: E126-E127.