Diagnostic approach in symptomatic or asymptomatic aneurismal disease of the coronary arteries: a case report and five-year angiographic follow up.

Coronary artery aneurysms are rare anomalies that are usually incidental findings in coronary angiography. We present the case of a 64-year-old male patient with a recent episode of epigastric pain, nausea and vomiting, accompanied by electrocardiographic alterations and positive troponin I. As the symptoms persisted, the patient was referred for coronary angiography, during which a significant degree of aneurysmal dilatation was found in all three coronary vessels along their length. Oral administration of anticoagulants was decided upon. After five years of follow up, a new coronary angiogram was recorded, which showed no aggravation of the aneurysmal dilatations, while the patient was free of symptoms.