Hussain Mahmud, Naveed Akhtar.
Left main coronary artery aneurysm associated with severe atherosclerosis: a case report from Pakistan.
J Pak Med Assoc Jan ;54(12):638-9.

A 55 year old non-insulin dependent diabetic, obese female presented with recent onset chest pain along with exertional dyspnea of two years duration. This was associated with palpitations and dizziness. There were no features suggestive of Kawasaki`s disease in the history. The physical examination was unremarkable. The ECG showed nonspecific ST segment changes present in anterior chest leads. Coronary angiography was performed which showed a large fusiform aneurysm (Figure) of about 15 mm diameter at its widest point at the bifurcation of the Left main coronary artery (LMCA). This was associated with severe stenosis of Left anterior descending artery (LAD) and Circumflex artery. Furthermore sub-total occlusion of the Right coronary artery (RCA) was also observed. Coronary artery bypass graft (CABG) surgery was advised; however the patient opted for surgery abroad. Since then, she has been lost to follow-up.

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