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Background: Primary hyperaldosteronism as a cause of coronary artery ectasia has only been reported one time in the literature, and here we report the second presentation of this very rare association.
Case Summary: A 67-year-old man, with a history of treatment-resistant hypertension, was admitted to intensive care unit of cardiology for N-STEMI. His coronary angiography revealed an ectasia of all three major coronary arteries without significant luminal obstruction (TIMI III); and he was put on Dual antiplatelet therapy. Etiological assessment found an Idiopathic primary hyperaldosteronism, and our patient is actually on spironolactone with good blood pressure controls.
Conclusion: Early treatment of primary hyperaldosteronism and a good therapeutic approach for coronary ectasia are important to prevent any lifethreatening complications.