A large congenital aneurysm, arising from the first diagonal branch of the left anterior descending artery in a 52 year old woman was diagnosed by transoesophageal echocardiography, computed tomography, and magnetic resonance imaging. Surgical closure of the aneurysm was successful. (Br HeartJ7 1993;70:274-275) Large congenital aneurysms of the coronary arteries are rare.'-5 Most of the reported aneurysms were diagnosed at necropsy, and rarely by non-invasive methods before coronary angiography.6 We report a patient in whom a large coronary arterial aneurysm was diagnosed by transoeosophageal echocardiogram, computed tomography, and magnetic resonance imaging before operation.Case report A 52 year old woman was admitted to hospital with a five month history of chest tightness and cough. She had episodes of non-exertional chest tightness lasting five minutes. This was generally followed by coughing that produced mucoid sputum. She was a nonsmoker. Her (fig 3).The other branches of the coronary artery were all normal. The aneurysm was partially filled by thrombus. The patient underwent marsupialisation of the aneurysm. She has remained symptom free since surgery.
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