Coronary artery ectasia presenting with ST-elevation myocardial infarction in a young indigenous man: a case report

Background Coronary artery ectasia (CAE) is often an incidental finding on angiography, however, patients can present with acute coronary syndrome due to a large thrombus burden requiring treatment with percutaneous coronary intervention or with emergency surgery. Case summary A 26-year-old Indigenous Australian male was admitted with anterior ST-elevation myocardial infarction associated with an out of hospital ventricular fibrillation arrest. Coronary angiography demonstrated thrombotic occlusion of the proximal left anterior descending (LAD) artery with heavy thrombus burden and prominent vascular ectasia of all three coronary arteries. He was managed with surgical thrombectomy and coronary artery bypass graft of his LAD. Discussion This is the first case of triple CAE in an Indigenous Australian. The case highlights the lack of consensus approach in the management of CAE due to paucity of prospective studies.