Multi-vessel giant coronary artery aneurysm in an elderly female.

Coronary artery aneurysm (CAA) is a rare anomaly. The right coronary artery is the most commonly affected, followed by the left circumflex (LCX), or the left anterior descending artery (LAD). Three-vessel disease or left main (LM) involvement is extremely rare. A giant coronary artery aneurysm (GCAA) has an extremely low incidence and refers to an aneurysm that is 20 mm or greater in size. Most CAAs occur as a consequence of atherosclerosis. Most patients with CAA are males, have three-vessel disease, and a history of myocardial infarction (MI). Thrombosis within the aneurysm can lead to distal embolization and MI. Depending on the severity of coronary stenosis, management of patients with LM CAAs is either surgical or medical.