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A 30-year old presented with an acute coronary syndrome. Angiography demonstrated an aneurysm of a large diagonal artery (panel A) but no coronary stenosis. Cardiac CT angiography (CCTA) confirmed a fusiform aneurysm with thrombus (panel B) and the culprit subtotally occluded side branch. Spotty calcification suggested that the aneurysm was chronic (panel B inset). A perfusion defect in the territory supplied by the occluded vessel …
Competing interests None.
Provenance and peer review Not commissioned; not externally peer reviewed.