Abstract

Background

Coronary artery aneurysms (CAAs) are focal dilation of a coronary segment (≥1.5 times the adjacent regular segment). Etiological factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease (KD), and percutaneous coronary intervention. Potential complications are thrombosis, rupture, and embolism. "Giant" CAA is generally referring to a dilatation that exceeds the reference vessel diameter by four times, and the reported incidence is 0.02%.

 Case Presentation

 We present an interesting case of 66 years old female encountered to establish primary care with presenting complaints of right lower leg cellulitis. Echocardiography was ordered considering the previous history of MRSA-positive cellulitis and decreased exercise tolerance. A preliminary diagnosis of Right atrium cystic tumor was made. Further radiological evaluations confirmed a giant right coronary artery aneurysm—the potential near-miss timely managed by exclusion surgery.

 Conclusion 

 Giant coronary artery aneurysms mimicking an intra-cardiac mass are extremely rare and poorly understood. Coronary artery aneurysm is mostly detected incidentally on an angiogram or at autopsy. However, an aneurysm could be suspected by a competent family physician in patients with a varied cardiac presentation. Comprehensive preoperative evaluation is highly recommended because surgical strategies for tumors and aneurysms are entirely different.