# Unexpected Giant Right Coronary Artery Aneurysm Diagnosed by Computed Tomography Angiography in the Emergency Department

## TL;DR

A rare giant aneurysm in a coronary artery was successfully diagnosed using computed tomography angiography in an emergency setting.

## Contribution

This case highlights the effectiveness of CTA in emergency diagnosis of giant coronary artery aneurysms.

## Key findings

- CTA provided detailed visualization of a giant thrombosed aneurysm in the right coronary artery.
- CTA enabled the detection of life-threatening complications associated with the aneurysm.
- The case demonstrates the utility of CTA as a non-invasive alternative to coronary angiography in emergency settings.

## Abstract

Giant coronary artery aneurysms (GCAA) are usually defined as diameter > 8 mm or > 400% of the adjacent normal segment; they are very rare (reported prevalence ≈0.02%). Though coronary angiography is the diagnostic gold standard, computed tomography angiography (CTA) offers a non‐invasive, highly sensitive, and specific alternative. CTA enables detailed visualization of aneurysm morphology and detection of complications. We present the case of a 72‐year‐old man admitted to the Emergency Department with chest pain, where CTA played a crucial role in diagnosing a GCAA and assessing its potential life‐threatening complications, highlighting its value in emergency cardiovascular imaging.

3D Volume Rendering coronary CTA reconstruction showing a giant thrombosed aneurysm of the proximal right coronary artery