Infected coronary artery aneurysms present high mortality and surgical
management is the treatment of choice in most cases. We present a case
of a giant infected aneurysm of the mid right coronary artery
complicated with purulent pericarditis in an 83-year-old male patient.
It is unknown whether the aneurysm or purulent pericarditis preceded.
The patient underwent urgent aneurysm resection and coronary artery
distal bypass grafting. He died 24 hours after the operation. When
purulent pericarditis and ICAA co-exist the riddle of the chicken and
the egg becomes apparent.