Abstract
Giant coronary artery aneurysm (CAA) is a rare and often underreported condition, most frequently associated with atherosclerosis but also linked to congenital, inflammatory, and connective tissue disorders. Unlike typical atherosclerotic disease, there is limited evidence regarding the most effective diagnostic tools, treatment options, and prognostic implications for patients with giant CAAs. The left main coronary artery (LMCA) is an especially uncommon location, where management decisions can be particularly complex due to the lack of established guidelines. We present the case of a young patient with a giant aneurysm of the LMCA who was successfully treated with conservative medical therapy and remained asymptomatic after six months of follow-up without surgical or percutaneous intervention. This report highlights the challenges in choosing appropriate management strategies for giant CAAs and emphasizes the importance of individualized, patient-centered care. It also underscores the need for further studies to develop evidence-based recommendations for diagnosing and treating this rare but clinically significant condition.