Rapidly Growing Coronary Aneurysm Following Purulent Pericarditis
Yuriy Stukov1, Andrii Gavrylyshin2, Sergiy Salo2
1Department of Surgery, University of Florida, Gainesville, Florida, US.
Abstract:
Pericardiocentesis is associated with occasional infectious complications. Infected coronary artery aneurysms are rare and develop in patients undergoing coronary angiography. We describe a case of a 68-year-old man with prior myocardial infarction who presented with shortness of breath and chest pain 2 weeks after upper respiratory infection. After further workup revealed moderate pericardial effusion, the patient underwent pericardiocentesis and coronary angiography, which revealed multivessel coronary artery disease. The patient was transferred for elective surgical revascularization, which revealed a thickened pericardium with purulent pericardial fluid, suggestive of effusive constrictive pericarditis. Due to the risk for infectious complications, percutaneous coronary intervention was planned after antibiotic treatment. Repeat angiography revealed a coronary artery aneurysm in the proximal left anterior descending and diagonal 1 branch bifurcation, which was closed using an Mguard stent (Inspire MD) with an integrated polyethylene terephthalate net. Complete obliteration of the aneurysm was obtained using this approach.
Insights
Infectious complications from pericardiocentesis are rare. This case highlights a rare infected coronary artery aneurysm successfully treated with a specialized stent after initial diagnosis via coronary angiography.
Area of Science:
- Cardiology
- Infectious Diseases
- Interventional Cardiology
Background:
- Pericardiocentesis can lead to infectious complications.
- Infected coronary artery aneurysms are uncommon, often seen post-coronary angiography.
- Effusive constrictive pericarditis can present with purulent pericardial fluid.
Related Concept Videos
Pericarditis II: Clinical Features and Diagnostic Tests
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Pericarditis I: Introduction
Rheumatic Heart Disease I: Introduction
Pericarditis III: Medical Management
Aneurysm III: Interprofessional Care


