Ruptured saccular aneurysm of a coronary artery to pulmonary artery fistula associated with cardiac tamponade

We reported a case of ruptured saccular aneurysm of coronary artery to pulmonary artery fistula. The patient was a 59-year-old woman who was admitted for loss of consciousness and cardiogenic shock. Echocardiogram and computed tomography revealed cardiac tamponade. Rupture of saccular aneurysm of a coronary artery to pulmonary artery fistula was diagnosed by coronary angiography. Emergent pericardial drainage was performed, but she developed shock due to cardiac tamponade. The aneurysm was resected on a beating heart. The postoperative course was uneventful.