Urgent Coronary Artery Bypass Grafting Due to Multi- Vessel Coronary Aneurysm

Coronary Artery Aneurysm (CAA) is defined as a dilation of more than 1.5 times normal in a segment of the coronary artery. While the incidence of CAA is highest in the Right Coronary Artery (RCA), it is agreed that left main coronary artery or three-vessel involvement is extremely rare. Wide ranges of factors have been implicated in the cause of CAA with atherosclerosis being the most common at 50%. Congenital CAA occurs in 20-30% of cases followed by connective tissue disease at 10%. Blood stagnation and exposure of the underlying collagen make aneurysms prone to thrombosis, dissection, and vasospasm. Depending on the size, symptoms, and etiology of the aneurysms; a surgical, percutaneous, or medical approach may be used. In this paper, we are presenting a patient who presented to the emergency department (ED) with chest pain due to Acute Coronary Syndrome (ACS) that was found to be due to multi-vessels CAAs involving the left main as well as RCA, Left Anterior Descending (LAD) artery and Left Circumflex Artery (LCA) requiring urgent Coronary Artery Bypass Grafting (CABG).