CTICasesLeft Main Coronary Artery Aneurysm
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Imaging findings
Cardiac CT of a young patient (41 or 42 years old) demonstrates a focal, relatively large aneurysm of a long left main coronary artery, located proximal to its bifurcation. There is only a minute dot of calcification within the artery wall and an absence of diffuse atherosclerotic disease or aneurysmal dilatation elsewhere in the coronary tree.
Key takeaways
Coronary artery aneurysms are most commonly caused by advanced atherosclerosis in adults, or by Kawasaki disease (which histologically behaves as a false aneurysm due to the destruction of the arterial media). In a young patient without systemic atherosclerotic disease, a solitary left main coronary artery aneurysm may represent a congenital vascular variant, an old sequela of undiagnosed Kawasaki disease, or a rare localized connective tissue disorder.
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