Coronary artery aneurysm (CAA) is an uncommon clinical finding, with an incidence varying from 1.5%-4.9% in adults, and is usually considered a variant of coronary artery disease (CAD). CAA identified in the context of acute coronary syndrome (ACS) represents a unique management challenge, particularly if the morphology of the CAA is suspected to have provoked the acute clinical syndrome. We report a case of 33-year-old male who presented with chest pain. Chest radiography showed no cardiomegaly, and electrocardiography showed inverted T waves in lead III. Echocardiography showed no regional wall motion abnormality and good biventricular function. CT Coronary angiogram showed Left Anterior Descending artery ectasia with distal segment giant bilobed aneurysm.The patient was discharged on medical management with aspirin and warfarin therapy and advised to be on regular follow up. At 6 months' follow-up, he remained asymptomatic.
