BACKGROUND Inflammation of the aortic wall, known as aortitis, is a rare 
clinical entity which is frequently asymptomatic, or identified when the patient 
presents with an aortic aneurysm or dissection. It is most often caused by 
infection or autoimmune vasculitides such as giant cell or Takayasu's arteritis. 
CASE REPORT The case presented is that of a 55-year-old man with symptomatic 
occlusion of the right coronary artery caused by a plasmacytic aortitis 
suggestive of IgG4 disease, which was successfully treated with coronary artery 
bypass grafting and an ascending aortic graft. CONCLUSIONS A review of the 
current literature emphasizes how poorly the etiology and natural history of 
plasmacytic aortitis is understood.