Post-PTCA pericardial abscess from stent infection: Late-onset coronary stent infection presenting as pericardial abscess

Title : Post-PTCA pericardial abscess from stent infection: Late-onset coronary stent infection presenting as pericardial abscess

Abstract:

We present a rare case of coronary stent infection that developed after two months of Percutaneous Transluminal Coronary Angioplasty forming a localized pericardial abscess caused by Pseudomonas aeruginosa. 51-year-old male with T2DM, Hypertension, Anterior wall STEMI and had a double vessel disease on primary angiography and underwent angioplasty of mid LAD artery with PCI to RCA. He was admitted with fever, weight loss for 2 months, and typical chest pain of the pericardial type for 2 weeks. ECG showed T wave inversion in V2 –V5, Echo revealed localized collection anterior to right ventricle within pericardial cavity. CECT chest showed localized right pericardial abscess near the RCA stent, which was found to be fractured into 2 parts on angiogram and distal strut moving freely within pericardium. He was managed with iv antibiotics, abscess drainage and LIMA to LAD graft. Coronary stent infections are extremely uncommon and can be life-threatening if missed. This case highlights the importance of maintaining a suspicion for device-related infections in patients with atypical symptoms after intervention.

Biography:

Dr. Kumar studied MBBS at the Government Medical College Jammu, India and graduated in 2023. He gave his USMLE Step 1 and OET and went for clinical rotations for US clinical experience in 2024. He rotated at Cleveland Clinic and HCA Clear Lake in the department of Cardiology. He then joined the Junior Residency at All India Institute of Medical Sciences, New Delhi in 2025. He want to pursue his Internal Medicine Residency in the US and later wants to do Cardiology. He is interested in research and reporting interesting cases, collaborating and presenting to get to learn from the cardiology community.