Two presentations of acute coronary syndrome with progression of giant right coronary artery aneurysm; a case report

BACKGROUND: Giant coronary aneurysms are a rare finding on coronary angiography. Given its very low prevalence, little is known about optimal management of this coronary pathology. CASE SUMMARY: In this case report, we review the two presentations of a patient with acute coronary syndrome during a 6-year period. With regard to the second presentation, we review the investigations that demonstrate the progression of a coronary aneurysm in the right coronary artery as well as the Heart Team evaluations that resulted in surgical treatment of the coronary aneurysm. DISCUSSION: Following perspectives on prevalence and risk factors, we emphasize upon the available data with regard to interventional options in coronary aneurysms and describe the considerations with regard to interventional treatment in patients with giant coronary aneurysms. Finally, we discuss the available literature with regard to antithrombotic regimens in patients with coronary aneurysms.