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Electrocardiogram showing ST segment depression in inferior and apico-lateral leads
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EKG showed regular sinus rhythm with ST segment depression in inferior and apicolateral leads (Figure 1).
Transesophageal echocardiography, short axis view showing an aneurysmal mass contacting the pulmonary artery
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Though, there was a huge aneurysmal mass measuring approximately 58*47 mm, arising from the left coronary artery and distorting the lateral wall of the left ventricle (LV) and the pulmonary artery (PA) without creating an authentic right outflow tract obstruction (Figure 2).
Coronary angiography revealing a thrombosed aneurysm of the left coronary artery
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We performed coronary angiography that showed a severe stenotic lesion of the proximal segment of the LAD localized opposite to a huge aneurysm of about 3 cm in size inducing a coronary steal phenomenon with a delayed opacification of the distality of the vessel (Figure 3).
CT angiography identifying a saccular thrombosed aneurysm of the proximal segment of the LAD
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On computed tomography (CT) angiography, there was a saccular thrombosed aneurysm of the proximal segment of the LAD measuring 3cm with a neck portion of 4.3 mm (Figure 4).
Peroperative view of the thrombus filling the aneurysmal sac
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Peroperative exploration identified the aneurysmal sac filled with a big thrombus and contacting the lateral wall of the LV and the PA (Figure 5).