Coronary artery aneurysm (CAA) is defined as the diameter of the lumen of the coronary artery, generally exceeding 1.5 times the normal adjacent segment, which may involve less than one third of the whole length of the vessel (Tunick et al. 1990; Kruger et al. 1999). Another similar pathology, i.e. coronary artery ectasia (CAE), is also characterised by dilatation of the coronary artery, with a diameter exceeding 1.5 times, or more than the normal adjacent segment. However, the difference between CAA and CAE is that CAE is more diffuse, affecting more than one third of the length of the coronary artery (Aboeata et al. 2012). Based on the size of the aneurysm, it can be considered as a giant coronary aneurysm, if the diameter is more than 20 mm (Jha et al. 2009).
According to a survey conducted by Daoud et al. (1963), the majority of coronary aneurysm (more than 50%) was caused by atherosclerosis, followed by congenital disorders and mycotic and syphilitic diseases (Daoud et al. 1963). The results were similar to that by Luo et al. (2016), where 68.2% of patients with CAA had coronary artery disease (CAD), in comparison to only 39.2% of CAE patients, who had CAD (Luo et al. 2016). Post-coronary intervention and connective tissue disorder were among the conditions reported in the incidence of coronary artery aneurysm (Swaye et al. 1983; Rognoni et al. 2007).
Patients with aneurysm of the coronary artery may be asymptomatic. However, it can cause fatal complications such as myocardial infarction and cardiac tamponade. We, thus, reported a case of sudden death due to ruptured aneurysm of coronary artery in a 53-year-old male, who had no history of connective tissue disorder prior to his death.