{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:55:33Z","timestamp":1787921733561,"version":"build-2784847793"},"reference-count":32,"publisher":"Texas Heart Institute Journal","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"Giant aneurysm of the left main coronary artery is exceedingly rare and accounts for less than 2% of patients undergoing coronary angiography. The etiology varies depending on the patient's age and geographic area, but half are of atherosclerotic origin. In most cases, coronary aneurysms are asymptomatic, however, symptomatic patients present with symptoms characteristic of coronary artery disease such as chest pain (angina pectoris), myocardial infarction, congestive heart failure, and even sudden death. Coronary angiography is considered the gold standard tool to determine the presence or absence of coronary artery disease, and if present, its size and location. Herein, we report a case of giant aneurysm of the left main coronary artery presenting as syncope and documented nonsustained ventricular tachycardia.<\/jats:p>","DOI":"10.14503\/thij-21-7557","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T16:06:14Z","timestamp":1665590774000},"source":"Crossref","is-referenced-by-count":1,"title":["Syncope in a Patient With Giant Left Main Coronary Aneurysm: Is There a Link With Ventricular Arrhythmias?"],"prefix":"10.14503","volume":"49","author":[{"given":"Kyriacos","family":"Papadopoulos","sequence":"first","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Christophides","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Eftychiou","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicos","family":"Eteokleous","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Mitsis","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Zittis","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiotis","family":"Avraamides","sequence":"additional","affiliation":[{"name":"Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5628","reference":[{"issue":"1","key":"i1526-6702-49-5-e217557-b1","series-title":"J Geriatr Cardiol.","doi-asserted-by":"publisher","first-page":"110","DOI":"10.3969\/j.issn.1671-5411.2013.01.016","article-title":"Giant saccular aneurysm of the left main coronary artery","volume":"10","year":"2013","unstructured":"Tuncer\n E,\n \n \n Onsel Turk\n U,\n \n \n Alioglu\n E.\n \n \n Giant saccular aneurysm of the left main coronary artery.\n\t\t\t\t\tJ Geriatr Cardiol.2013;10(1):110\u2013112.\n\t\t\t\t\tdoi:10.3969\/j.issn.1671-5411.2013.01.016"},{"issue":"3","key":"i1526-6702-49-5-e217557-b2","series-title":"J Thorac Cardiovasc Surg.","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1016\/j.jtcvs.2005.04.004","article-title":"Surgical treatment of giant coronary artery aneurysm","volume":"130","year":"2005","unstructured":"Li\n DY,\n \n \n Wu\n Q,\n \n \n Sun\n LZ,\n \n \n .\n\t\t\t\t\tSurgical treatment of giant coronary artery aneurysm.\n\t\t\t\t\tJ Thorac Cardiovasc Surg.2005;130(3):817\u2013821.\n\t\t\t\t\tdoi:10.1016\/j.jtcvs.2005.04.004"},{"issue":"1","key":"i1526-6702-49-5-e217557-b3","series-title":"Circulation.","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1161\/01.cir.67.1.134","article-title":"Aneurysmal coronary artery disease","volume":"67","year":"1983","unstructured":"Swaye\n PS,\n \n \n Fisher\n LD,\n \n \n Litwin\n P,\n \n \n .\n\t\t\t\t\tAneurysmal coronary artery disease.\n\t\t\t\t\tCirculation.1983;67(1):134\u2013138.\n\t\t\t\t\tdoi:10.1161\/01.cir.67.1.134"},{"issue":"6","key":"i1526-6702-49-5-e217557-b4","series-title":"Am Heart J.","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1016\/s0002-8703(05)80192-9","article-title":"Massive aneurysm of the left main coronary artery","volume":"119","year":"1990","unstructured":"Hawkins\n JW,\n \n \n Vacek\n JL,\n \n \n Smith\n GS.\n \n \n Massive aneurysm of the left main coronary artery.\n\t\t\t\t\tAm Heart J.1990;119(6):1406\u20131408.\n\t\t\t\t\tdoi:10.1016\/s0002-8703(05)80192-9"},{"key":"i1526-6702-49-5-e217557-b5","series-title":"Int J Angiol.","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s00547-004-1066-y","article-title":"Atherosclerotic left main coronary aneurysm","volume":"13","year":"2004","unstructured":"Huang\n CY,\n \n \n Huang\n CH,\n \n \n Chen\n JW,\n \n \n Liu\n TM.\n \n \n Atherosclerotic left main coronary aneurysm.\n\t\t\t\t\tInt J Angiol.2004;13:89\u201391.\n\t\t\t\t\tdoi:10.1007\/s00547-004-1066-y"},{"issue":"13","key":"i1526-6702-49-5-e217557-b6","series-title":"Am J Cardiol.","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1016\/0002-9149(91)90881-k","article-title":"Angiographic features of left main coronary artery aneurysms","volume":"67","year":"1991","unstructured":"Topaz\n O,\n \n \n Di Sciascio\n G,\n \n \n Cowley\n MJ,\n \n \n .\n\t\t\t\t\tAngiographic features of 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Niroomand\n F.\n \n \n Coronary artery aneurysm: a review.\n\t\t\t\t\tClin Cardiol.2006;29(10):439\u2013443.\n\t\t\t\t\tdoi:10.1002\/clc.4960291005"},{"issue":"6","key":"i1526-6702-49-5-e217557-b11","series-title":"Cardiol Rev.","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1097\/CRD.0b013e3181852659","article-title":"Coronary artery aneurysms: a review of the natural history, pathophysiology, and management","volume":"16","year":"2008","unstructured":"Cohen\n P,\n \n \n O'Gara\n PT.\n \n \n Coronary artery aneurysms: a review of the natural history, pathophysiology, and management.\n\t\t\t\t\tCardiol Rev.2008;16(6):301\u2013304.\n\t\t\t\t\tdoi:10.1097\/CRD.0b013e3181852659"},{"issue":"8828","key":"i1526-6702-49-5-e217557-b12","series-title":"Lancet.","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1016\/0140-6736(92)93152-d","article-title":"Adult coronary artery disease probably due to childhood Kawasaki 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Cardiol.1996;28(1):253\u2013257.\n\t\t\t\t\tdoi:10.1016\/0735-1097(96)00099-x"},{"issue":"6","key":"i1526-6702-49-5-e217557-b14","series-title":"Circulation.","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1161\/01. cir.94.6.1379","article-title":"Long-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients","volume":"94","year":"1996","unstructured":"Kato\n H,\n \n \n Sugimura\n T,\n \n \n Akagi\n T,\n \n \n .\n\t\t\t\t\tLong-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients.\n\t\t\t\t\tCirculation.1996;94(6):1379\u20131385.\n\t\t\t\t\tdoi:10.1161\/01. cir.94.6.1379"},{"issue":"1","key":"i1526-6702-49-5-e217557-b15","series-title":"J Pediatr.","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.jpeds.2007.12.021","article-title":"Resistance to intravenous immunoglobulin in children with Kawasaki disease","volume":"153","year":"2008","unstructured":"Tremoulet\n AH,\n \n \n Best\n BM,\n \n \n Song\n S,\n \n \n .\n\t\t\t\t\tResistance to intravenous immunoglobulin in children with Kawasaki disease.\n\t\t\t\t\tJ Pediatr.2008;153(1):117\u2013121.\n\t\t\t\t\tdoi:10.1016\/j.jpeds.2007.12.021"},{"issue":"9","key":"i1526-6702-49-5-e217557-b16","series-title":"J Am Heart Assoc.","doi-asserted-by":"publisher","first-page":"e003289","DOI":"10.1161\/JAHA.116.003289","article-title":"Coronary artery aneurysms in Kawasaki disease: risk factors for progressive disease and adverse cardiac events in the US population","volume":"5","year":"2016","unstructured":"Friedman\n KG,\n \n \n Gauvreau\n K,\n \n \n Hamaoka-Okamoto\n A,\n \n \n .\n\t\t\t\t\tCoronary artery aneurysms in Kawasaki disease: risk factors for progressive disease and adverse cardiac events in the US population.\n\t\t\t\t\tJ Am Heart Assoc.2016;5(9):e003289.\n\t\t\t\t\tdoi:10.1161\/JAHA.116.003289"},{"issue":"2","key":"i1526-6702-49-5-e217557-b17","series-title":"J Am Coll 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presenting with non-ST elevation myocardial infarction and severe mitral regurgitation: a case report.\n\t\t\t\t\tJ Med Case Rep.2011;5:442.\n\t\t\t\t\tdoi:10.1186\/1752-1947-5-442"},{"issue":"5","key":"i1526-6702-49-5-e217557-b19","series-title":"Chest.","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1378\/chest.69.5.630","article-title":"Coronary artery aneurysm. 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A review of the literature with a report of 11 new cases.\n\t\t\t\t\tChest.1976;69(5):630\u2013636.\n\t\t\t\t\tdoi:10.1378\/chest.69.5.630"},{"issue":"15 suppl","key":"i1526-6702-49-5-e217557-b20","series-title":"J Am Coll Cardiol.","first-page":"S363","article-title":"TCTAP C-155 thrombosed giant coronary artery aneurysms presenting with ventricular tachycardia","volume":"79","year":"2022","unstructured":"Hamidi\n MHM,\n \n \n Kadir\n RFA,\n \n \n Sani\n H,\n \n \n Radzi\n ABM,\n \n \n Abidin\n HAZ.\n \n \n TCTAP C-155 thrombosed giant coronary artery aneurysms presenting with ventricular tachycardia.\n\t\t\t\t\tJ Am Coll Cardiol.2022;79(15 suppl):S363\u2013S366."},{"issue":"4","key":"i1526-6702-49-5-e217557-b21","series-title":"Am J Cardiol.","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/s0002-9149(99)00335-5","article-title":"Coronary arterial involvement and QT dispersion in Kawasaki disease","volume":"84","year":"1999","unstructured":"Osada\n M,\n \n \n Tanaka\n Y,\n \n \n Komai\n T,\n \n \n .\n\t\t\t\t\tCoronary arterial involvement and QT dispersion in Kawasaki disease.\n\t\t\t\t\tAm J Cardiol.1999;84(4):466\u2013468.\n\t\t\t\t\tdoi:10.1016\/s0002-9149(99)00335-5"},{"issue":"5","key":"i1526-6702-49-5-e217557-b22","series-title":"Pediatr Cardiol.","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1007\/s00246-001-0072-5","article-title":"Electrocardiographic depolarization and repolarization: long-term after Kawasaki disease","volume":"23","year":"2002","unstructured":"Dahdah\n NS,\n \n \n Jaeggi\n E,\n \n \n Fournier\n A.\n \n \n Electrocardiographic depolarization and repolarization: long-term after Kawasaki disease.\n\t\t\t\t\tPediatr Cardiol.2002;23(5):513\u2013517.\n\t\t\t\t\tdoi:10.1007\/s00246-001-0072-5"},{"key":"i1526-6702-49-5-e217557-b23","series-title":"Int J Cardiol.","doi-asserted-by":"publisher","first-page":"5286","DOI":"10.1016\/j.ijcard.2017.08.011","article-title":"Increased inflammation promotes ventricular arrhythmia through aggravating left stellate ganglion remodeling in a canine ischemia model","volume":"248","year":"2017","unstructured":"Wang\n M,\n \n \n Li\n S,\n \n \n Zhou\n X,\n \n \n .\n\t\t\t\t\tIncreased inflammation promotes ventricular arrhythmia through aggravating left stellate ganglion remodeling in a canine ischemia model.\n\t\t\t\t\tInt J Cardiol.2017;248:5286\u2013293.\n\t\t\t\t\tdoi:10.1016\/j.ijcard.2017.08.011"},{"issue":"4","key":"i1526-6702-49-5-e217557-b24","series-title":"Eur J Echocardiogr.","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.euje.2004.02.003","article-title":"Coronary artery aneurysms mimicking cardiac tumor","volume":"5","year":"2004","unstructured":"Anfinsen\n OG,\n \n \n Aaberge\n L,\n \n \n Geiran\n O,\n \n \n Smith\n HJ,\n \n \n Aakhus\n S.\n \n \n Coronary artery aneurysms mimicking cardiac tumor.\n\t\t\t\t\tEur J Echocardiogr.2004;5(4):308\u2013312.\n\t\t\t\t\tdoi:10.1016\/j.euje.2004.02.003"},{"issue":"3","key":"i1526-6702-49-5-e217557-b25","series-title":"Vasc Med.","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.jacc.2015.12.073","article-title":"Kawasaki disease","volume":"4","year":"1999","unstructured":"Newburger\n J,\n \n \n Burns\n J.\n \n \n Kawasaki disease.\n\t\t\t\t\tVasc Med.1999;4(3):187\u2013202.\n\t\t\t\t\tdoi:10.1016\/j.jacc.2015.12.073"},{"issue":"5","key":"i1526-6702-49-5-e217557-b26","series-title":"J Thorac Cardiovasc Surg.","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1016\/j.jtcvs.2004.03.027","article-title":"Surgical management of a giant left main coronary artery aneurysm","volume":"128","year":"2004","unstructured":"Pinheiro\n BB,\n \n \n Fagundes\n WV,\n \n \n Gusm\u00e3o\n CA,\n \n \n Lima\n AM,\n \n \n Santos\n LH,\n \n \n Vieira\n GB.\n \n \n Surgical management of a giant left main coronary artery aneurysm.\n\t\t\t\t\tJ Thorac Cardiovasc Surg.2004;128(5):751\u2013752.\n\t\t\t\t\tdoi:10.1016\/j.jtcvs.2004.03.027"},{"issue":"3","key":"i1526-6702-49-5-e217557-b27","series-title":"Ann Thorac Cardiovasc Surg","first-page":"195","article-title":"Emergent operation for aneurysm of the left main coronary artery presenting acute myocardial infarction","volume":"10","year":"2004","unstructured":"Izumi\n Y,\n \n \n Yoshida\n H,\n \n \n Shimizu\n N,\n \n \n Kubota\n H.\n \n \n Emergent operation for aneurysm of the left main coronary artery presenting acute myocardial infarction.\n\t\t\t\t\tAnn Thorac Cardiovasc Surg.\n\t\t\t\t\t2004;10(3):195\u2013197."},{"issue":"1","key":"i1526-6702-49-5-e217557-b28","series-title":"Interact Cardiovasc Thorac Surg.","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1093\/icvts\/ivw292","article-title":"Surgical treatment of a giant left main aneurysm","volume":"24","year":"2017","unstructured":"Viola\n L,\n \n \n Keita\n L,\n \n \n Veerasingam\n D.\n \n \n Surgical treatment of a giant left main aneurysm.\n\t\t\t\t\tInteract Cardiovasc Thorac Surg.2017;24(1):138\u2013139.\n\t\t\t\t\tdoi:10.1093\/icvts\/ivw292"},{"issue":"2","key":"i1526-6702-49-5-e217557-b29","series-title":"Catheter Cardiovasc Interv.","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/ccd.20269","article-title":"Treatment of a coronary aneurysm involving bifurcation with the use of a custom-made polytetrafluoroethylene-covered bifurcation stent system","volume":"64","year":"2005","unstructured":"Iakovou\n I,\n \n \n Colombo\n A.\n \n \n Treatment of a coronary aneurysm involving bifurcation with the use of a custom-made polytetrafluoroethylene-covered bifurcation stent system.\n\t\t\t\t\tCatheter Cardiovasc Interv.2005;64(2):169\u2013172.\n\t\t\t\t\tdoi:10.1002\/ccd.20269"},{"issue":"7","key":"i1526-6702-49-5-e217557-b30","series-title":"J Invasive Cardiol","first-page":"387","article-title":"Use of a custom-made polytetrafluoroethylene-covered stent system for the treatment of a coronary aneurysm involving a bifurcation","volume":"17","year":"2005","unstructured":"Tassanawiwat\n W,\n \n \n Iakovou\n I,\n \n \n Colombo\n A.\n \n \n Use of a custom-made polytetrafluoroethylene-covered stent system for the treatment of a coronary aneurysm involving a bifurcation.\n\t\t\t\t\tJ Invasive Cardiol.\n\t\t\t\t\t2005;17(7):387\u2013389."},{"issue":"4","key":"i1526-6702-49-5-e217557-b31","series-title":"Cureus.","doi-asserted-by":"publisher","first-page":"7653","DOI":"10.7759\/cureus.7653","article-title":"Giant left main coronary artery aneurysm presenting as multiple implantable cardioverter defibrillator shocks","volume":"12","year":"2020","unstructured":"Malyshev\n Y,\n \n \n Syed\n A,\n \n \n Castillo\n R,\n \n \n Syed\n RA,\n \n \n Sahni\n S.\n \n \n Giant left main coronary artery aneurysm presenting as multiple implantable cardioverter defibrillator shocks.\n\t\t\t\t\tCureus.2020;12(4):7653.\n\t\t\t\t\tdoi:10.7759\/cureus.7653"},{"issue":"24","key":"i1526-6702-49-5-e217557-b32","series-title":"Eur Heart J.","doi-asserted-by":"publisher","first-page":"3058","DOI":"10.1093\/eurheartj\/ehm310","article-title":"Left main coronary artery aneurysm revealed by syncopal ventricular tachycardia in a 28-year-old woman","volume":"28","year":"2007","unstructured":"Lederlin\n M,\n \n \n Gerbaud\n E,\n \n \n Laurent\n F.\n \n \n Left main coronary artery aneurysm revealed by syncopal ventricular tachycardia in a 28-year-old woman.\n\t\t\t\t\tEur Heart J.2007;28(24):3058. \n\t\t\t\t\tdoi:10.1093\/eurheartj\/ehm310"}],"container-title":["Texas Heart Institute 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