Spontaneous coronary artery rupture treated on a beating heart.

Primary spontaneous coronary artery rupture (SCAR) without any underlying condition is a rare disorder. The acute and often dramatic nature of hemopericardium with cardiac tamponade advocates immediate pericardial drainage or surgical intervention with timely recognition of coronary artery rupture. This is the first case report of primary SCAR successfully treated on a beating heart without cardiopulmonary bypass.