Bifurcating aneurysm of the left main coronary artery involving left anterior descending and left circumflex arteries - A case report

Coronary artery aneurysm is a rare coronary abnormality, usually diagnosed incidentally by coronary angiography. Major causes of coronary aneurysms in clude coronary ectasia, Kawasaki disease, and atherosclerosis. Most of the discrete coronary aneurysms are of atherosclerotic origin. The incidence of atherosclerotic coronary aneurysms is about 0.2%, and the left main corona ry artery is the least frequently involved artery. Only a few cases of left main coronary artery aneurysm have been reported in the literature, and a left main coronary artery aneurysm involving the proximal segments of the l eft anterior descending and the left circumflex arteries has not been repor ted previously. The authors describe this finding in a man who presented wi th worsening exertional angina pectoris. Coronary angiography demonstrated an aneurysm of the distal left main coronary artery extending into the prox imal segments of the left anterior descending and the left circumflex arter ies. In addition, a significant flow-limiting atherosclerotic lesion was pr esent in the proximal portion of the left anterior descending artery distal to the aneurysm.