Introduction:
Coronary artery ectasia (CAE) and coronary artery aneurysm (CAA) are defined as localized or diffuse dilatation of at least 1.5 times the neighboring normal segments of the coronary artery1. CAE is defined as dilatation of more than one-third of the length of a coronary artery. In contrast, CAA is defined as dilatation of less than one-third of the length of a coronary artery. The prevalence of CAE is reported to be between 0.3% and 5.3% in patients receiving coronary angiography; similarly, the prevalence of CAA is reported to be between 1.5% and 4.9% in patients undergoing coronary angiography, considering these a rare finding1. Due to a lack of large-scale and long-term outcome studies, current guidelines do not contain explicit provisions for treating individuals with STEMI accompanied by an ectatic infarct-related artery (IRA)2. In adults, atherosclerosis accounts for almost half of the cases. Post-mortem studies show the presence of atherosclerotic plaque in aneurysmal segments of the affected coronary arteries, corroborating this theory1,2. We report a unique case with a massive CAA.