Abstract
This article reports a rare case of a 66-year-old female patient. The patient was admitted to the hospital due to multiple episodes of syncope over 5 days and was diagnosed with a possible congenital coronary artery-pulmonary artery fistula and ruptured coronary artery aneurysm. After admission, the patient received treatments including pericardiocentesis drainage and was subsequently transferred to the cardiac surgery department for operation. During surgery, a giant coronary artery aneurysm and multiple fistulous openings were discovered and successfully managed through a series of surgical procedures. The patient recovered well postoperatively with no residual fistulas or aneurysms. In this case, the combination of a giant coronary artery aneurysm with a coronary artery-pulmonary artery fistula is extremely rare, and the patient survived aneurysm rupture and cardiac tamponade before successfully undergoing surgery, providing valuable clinical experience for the diagnosis and treatment of similar diseases.