Intraoperative identification and treatment of a giant right coronary artery aneurysm.

: Giant coronary artery aneurysms are rare, difficult to diagnose, and have variable clinical presentations and treatment options. We demonstrate a case of a patient presenting with acute onset chest pain and signs of cardiac tamponade who then underwent a computed tomography pulmonary embolus protocol and was found to have hemopericardium with accumulation of contrast adjacent to the aorta. She then underwent emergent sternotomy and was found to have a large hemorrhagic mass on the right ventricle, which upon further dissection was determined to be a giant right coronary artery aneurysm with a site of contained rupture. Given the acuity of the presentation and the circumstances in which the giant coronary aneurysm was identified, the decision was made to ligate and bypass the affected coronary artery.