Giant coronary artery aneurysms: review and update

Tex Heart Inst J. 2014 Dec 1;41(6):603-8. doi: 10.14503/THIJ-13-3896. eCollection 2014 Dec.


Giant coronary artery aneurysms are rare, with a reported prevalence of 0.02% to 0.2%. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease, and percutaneous coronary intervention. Most giant coronary artery aneurysms are asymptomatic, but some patients present with angina pectoris, sudden death, fistula formation, pericardial tamponade, compression of surrounding structures, or congestive heart failure. Clinical sequelae include thrombus formation, embolization, fistula formation, and rupture. Surgical correction is generally accepted as the preferred treatment for giant coronary artery aneurysms. We present an illustrative case of a giant 70 × 40-mm coronary artery aneurysm in a 56-year-old man who declined surgery and died one month later. In addition, we provide a review of the medical literature on giant coronary artery aneurysms.

Keywords: Angina pectoris; aneurysm, dissecting/diagnosis/etiology/therapy; aneurysm, false; angina, unstable; anticoagulants/preventive use; coronary aneurysm/diagnosis/radiography/therapy/ultrasonography; coronary angiography; dilatation, pathologic; radiography, thoracic; stents; thromboembolism; tomography, x-ray computed; ultrasonography, interventional.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Asymptomatic Diseases
  • Cardiac Surgical Procedures
  • Coronary Aneurysm* / complications
  • Coronary Aneurysm* / diagnosis
  • Coronary Aneurysm* / surgery
  • Coronary Angiography / methods
  • Fatal Outcome
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Refusal