Coronary pseudoaneurysm: An uncommon cause of P.U.O. after a common procedure

Two and half months after successful primary angioplasty with stent implantation for an acute myocardial infarction, we were confronted with an unexplained fever of prolonged duration, after extensive work the cause of unexplained pyrexia was found to be related to development of hemorrhagic pericardial effusion secondary to leak from coronary pseudoaneurysm. The pseudoaneurysm was located in ostium of left anterior descending coronary artery. Despite review of the literature and an examination of the procedural data, we were unable to explain the cause of pseudoaneurysm formation. We assume that either the guidewire perforated the arterial wall when it passed the occlusion or a dissection not visualized angiographically, provoked this phenomenon.