A 70-year-old woman admitted with chest pain went into shock due to cardiac tamponade; 1000 mL of blood was drained from her pericardium. Enhanced computed tomography showed massive pericardial effusion and a coronary artery aneurysm in front of the main pulmonary artery. Coronary angiography revealed a coronary artery-pulmonary artery fistula and 3 giant saccular coronary artery aneurysms. Emergency surgical repair was successful.
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