Giant right coronary artery aneurysm in a dominant right system

Shafaqat Ali, Mahin Khan, Faryal Farooq, Hameem Changezi

Research output: Contribution to journalArticlepeer-review


Giant coronary artery aneurysms (GCAAs) are unusual and extremely rare. Due to their rarity, there is a lack of data on managing GCAAs. A man in his 70s who presented with worsening shortness of breath and bilateral lower extremity oedema was found to have non-ST elevation myocardial infarction. Coronary angiography showed a tortuous Shepherd's crook right coronary artery with ectasia and a gigantic 4.5×4 cm saccular aneurysm in the mid-right coronary artery with limited flow to the distal vasculature. He subsequently underwent aneurysmal clipping and excision with coronary artery bypass grafting. GCAAs are usually silent and diagnosed incidentally but can also present with variable cardiac symptoms. Treatment options include medical management, percutaneous coronary angioplasty and surgery. As per limited available literature, surgical resection has shown favourable outcomes, especially in symptomatic GCAAs. The patient reported significant symptomatic improvement on the follow-up office visit.

Original languageEnglish (US)
Article numbere253980
JournalBMJ Case Reports
Issue number8
StatePublished - Aug 9 2023
Externally publishedYes


  • cardiovascular medicine
  • interventional cardiology
  • ischaemic heart disease

ASJC Scopus subject areas

  • General Medicine


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