Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 1 2022 01 30 33 37 EN Erfan Kazemi 1. Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran. Hossein Sheibani Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Imam Ave., Shahroud, Iran 2021 08 19 2022 02 28 Coronary artery aneurysms (CAAs) are rare, and aneurysms of the left main coronary artery are extremely rare. Atherosclerosis is the main cause of CAAs. An 87-year-old man with atypical chest pain of 1 month’s duration presented to a hospital. Physical examinations of the patient’s cardiopulmonary system and vital signs were unremarkable. Electrocardiography showed a right bundle branch block and an atypical ST-segment elevation in the inferior leads. Coronary angiography demonstrated a huge aneurysm in the left main without any clots. Additionally, there were no remarkable findings in cardiac monitoring and spiral chest computed tomography scanning. Ultimately, after he received nitroglycerin, β-blockers, Ca++ channel blockers, Aspirin (ASA), and clopidogrel (Plavix), his pain was relieved. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1510 https://rhythm.tums.ac.ir/index.php/jthc/article/download/1510/1000