EDITED BY Leonardo Roever, Federal University of Uberlandia, Brazil REVIEWED BY Weichieh Lee, Chi Mei Medical Center, Taiwan *CORRESPONDENCE Tahere Davarpasand tahereh.davarpasand@yahoo.com RECEIVED 31 August 2023 ACCEPTED 14 November 2023 PUBLISHED 28 November 2023 CITATION Kalhor P and Davarpasand T (2023) Commentary: Coronary artery mycotic aneurysm in a patient suffering from subacute endocarditis: a case report and literature review. Front. Cardiovasc. Med. 10:1286416. doi: 10.3389/fcvm.2023.1286416 COPYRIGHT © 2023 Kalhor and Davarpasand. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Commentary: Coronary artery mycotic aneurysm in a patient suffering from subacute endocarditis: a case report and literature review Parvin Kalhor and Tahere Davarpasand * Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran KEYWORDS coronary artery mycotic aneurysm, bicuspid aortic valve (BAV), coronary artery ectasia (CAE), infective endocarditis (IE), congenital anomalies A Commentary on Coronary artery mycotic aneurysm in a patient suffering from subacute endocarditis: a case report and literature review By Parvin Kalhor and Tahereh Davarpasand (2023). Front. Cardiovasc. Med. 10:1286416. doi: 10. 3389/fcvm.2023.1286416 We read the case report titled “Coronary artery mycotic aneurysm in a patient suffering from subacute endocarditis: a case report and literature review” by Hali et al. (1) with great interest. In their study they reported a 42-year-old man who was referred with a 2-month history of feverishness and embolic ischemic left cerebellar infarction. He was diagnosed with infective endocarditis (IE) based on the results of echocardiography and blood culture by Viridans Streptococci organism. One of his echocardiographic findings was a bicuspid aortic valve (BAV) without aortic dilation. Before the surgery, a contrast-enhanced computed tomography (CT) scan revealed an irregular dilation of the left main coronary artery extending from the left coronary sinus to the proximal part of the left anterior descending artery. A diagnosis of coronary artery mycotic aneurysm (CAMA) was considered for him, but not without concerns. Septic condition and contrast-enhanced CT findings such as aneurysmal dilatation of the left main coronary artery with a diameter of 12.7 mm with an irregular border raised clinicians’ suspicion about CAMA in this patient; however, our concerns regarding this diagnosis are strong. It is more probable that the patient is suffering from both BAV and CAA, caused by congenital underlying causes that have unfortunately been followed by endocarditis at this age. CAMA is a rare and potentially fatal diagnosis that based on what is currently known, is considered a clinical diagnosis for patients. A study conducted by Restrepo et al. (2) on 55 CAMA patients showed that CAMA mostly occurred in men, the right coronary artery was the most affected vessel, and about 53.3% of the time, Staphylococcus aureus was the responsible organism. Some imaging findings may also be helpful to make us more fully suspect CAMA. A large lobulated or saccular shape aneurysm with mural thrombosis and thickened wall with tissue stranding around affected vessels in contrast-enhanced CT, in combination with an infective setting like fever, bacteremia, infective endocarditis, septic emboli, or recent interventional procedure, can raise our suspicion for TYPE General Commentary PUBLISHED 28 November 2023 | DOI 10.3389/fcvm.2023.1286416 Frontiers in Cardiovascular Medicine 01 frontiersin.org