LAUSR

Coronary artery aneurysms (CAA) may present with unstable angina, fistulae to the pulmonary artery, and left ventricle, and may mimic pericardial tamponade or a pericardial mass. We present images of a CAA presenting as an inta-pericardial mass. A 48-year-old asymptomatic femalewas referred for evaluation of an intra-pericardial 4-cm mass compressing the left atrium found on a routine pre-employment transthoracic echocardiogram. A computed tomography angiogram revealed a 3.4-cm left circumflex coronary artery aneurysm located within the atrioventricular groove (Figure 1). No other coronary lesions were noted. In view of the size of the CAA and the risk of rupture or fistulization to adjacent structures, she was advised to have surgical repair of the CAA. She refused and has remained stable at 1-year follow-up.