Spontaneous right coronary artery pseudoaneurysm

A 67-year-old man who had no history of coronary artery disease was found to have electrocardiographic abnormalities. Coronary angiography showed a proximal coronary artery aneurysm and total occlusion of the distal right coronary artery. He underwent coronary artery bypass grafting and repair of the right coronary artery aneurysm. The pathology of the resected aneurysm wall was compatible with a diagnosis of coronary pseudoaneurysm. Spontaneous coronary artery pseudoaneurysm is a rare condition that has the potential risk of rupture or ischemia. Surgical repair and adequate coronary revascularization are reasonable for a possible coronary artery pseudoaneurysm.