Coronary aneurysm and purulent pericardial effusion: old disease with an unusual cause.

We describe the case of a 60-year-old man with prior rotational atherectomy and drug-eluting stent to the left anterior descending artery (LAD) who presented with shortness of breath and chest pain 8 weeks after stent placement. Further workup revealed a large pericardial effusion with gram stain positive for methicillin-resistant Staphylococcus aureus. Subsequently, this was shown to be related to an aneurysm at the site of the prior LAD stent. This case demonstrated coronary stent infection with mycotic aneurysm and purulent pericardial effusion as an extremely rare but serious complication of percutaneous coronary intervention.