Acute Coronary Syndrome Caused by Coronary Artery Mycotic Aneurysm Due to Late Stent Infection Localized With Radiolabeled Autologous Leukocyte Imaging

Mycotic coronary artery aneurysm presenting as acute coronary syndrome is an uncommon but fatal condition. The diagnosis of mycotic aneurysm can be very challenging and difficult. Therefore, a high index of suspicion along with the use of multimodality imaging may help to diagnose this condition in patients with a prior history of coronary artery bypass grafting or percutaneous coronary intervention with persistent bacteremia with no identifiable source of infection. This case highlights a possibility of late stent infection and its association to drug eluting stents.