History And Admission Findings: A 28-year-old man without a significant past medical history presented to our emergency department with severe chest pain and dyspnoa. Vital signs and the rest of the physical examination were unremarkable.
Investigations: The electrocardiogram showed T-wave inversions and the cardiac enzymes were elevated.
Treatment And Course: Angiocardiography showed an aneurysm of the right coronary artery and a thrombus formation in its distal part. Intracoronary thrombolytic therapy was attempted an oral anticoagulation was started. Further investigations did not find the cause of the aneurysmatic RCA. The patient had no further episode of chest pain.
Conclusion: Acute coronary syndrome is a rare finding in patients under the age of 30 years. Coronary aneurysms with associated thrombus can be the cause of it.
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