DOI: 10.12890/2026_006148

Thromboembolic NSTEMI from a 9.4 × 7.3 mm mid-left circumflex artery aneurysm with a zero calcium score and non-obstructive coronary arteries

Authors

  • Abdelrahman Shehata College of Medicine, Gulf Medical University, Ajman, UAE
  • Gargi Sharma College of Medicine, Gulf Medical University, Ajman, UAE
  • Md Abdus Sakur College of Medicine, Gulf Medical University, Ajman, UAE
  • Alina Hakim College of Medicine, Gulf Medical University, Ajman, UAE
  • Dristi Naraindas Varandani Thumbay University Hospital, Ajman, UAE
  • Mohamed Hussien Abbas Cardiology Department, Rashid Hospital, Dubai, UAE

abdoseif990000@gmail.com

Keywords

Coronary artery aneurysm, NSTEMI, thromboembolism, zero calcium score, non-obstructive coronary artery disease

Abstract

Introduction: Coronary artery aneurysms (CAAs) are uncommon and can cause acute coronary syndromes due to thromboembolism despite the absence of obstructive coronary disease.
Case description: We report the case of a 51-year-old patient with hypertension and hypercholesterolemia with the chief complaint of chest pain and elevated troponin, which is typical of non-ST-segment elevation myocardial infarction (NSTEMI). Coronary angiography showed non-obstructive coronary arteries and a calcium score of 0 with 9.4 x 7.3 mm middle-left circumflex artery aneurysm with thrombosis. Thrombus aspiration was effectively done without stenting. The patient was treated using dual antiplatelet therapy and statin therapy, and clinical improvement was achieved. The case in point demonstrates an infrequent pathophysiology of NSTEMI due to thromboembolism in a tiny aneurysm without severe atherosclerosis. Multimodality imaging was essential for diagnosis. Management was conservative. Transthoracic echocardiography revealed mild left ventricular hypertrophy with inferior hyperkinesia along with preserved ejection fraction. The patient was hemodynamically stable throughout hospitalization and was discharged on optimal medical therapy having no recurrent symptoms.
Conclusion: NSTEMI may be caused by small CAAs through thromboembolism even though the coronary artery calcium score is zero. Personalized care (thrombus aspiration and optimal medical therapy) can yield excellent outcomes.

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References

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Published

2026-05-14

Issue

Vol. 13 No. 6 (2026)

Categories

How to Cite

1.
Shehata A, Sharma G, Sakur MA, Hakim A, Naraindas Varandani D, Hussien Abbas M. Thromboembolic NSTEMI from a 9.4 × 7.3 mm mid-left circumflex artery aneurysm with a zero calcium score and non-obstructive coronary arteries. EJCRIM [Internet]. 2026 May 14 [cited 2026 Nov. 3];13(6). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6148

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