Acute Coronary Syndrome With Giant Pancoronary and Ascending–Descending Aortic Aneurysms

A 62-year-old man with a history of hypertension and chronic obstructive pulmonary disease presented with an anterior ST-segment elevation myocardial infarction. Thrombolysis preceded imaging, which showed a 31-mm left main coronary aneurysm and ≥20-mm right coronary aneurysm with diffuse thrombosis and arch dilatation. Triple coronary artery bypass grafting and aortic arch endografting were performed 10 days later; however, the patient developed refractory mixed shock and, without ECMO/Impella, died 48 hours postoperatively.