Article Title

Coronary Artery Fistula


Wai-Fat Lam


An 85 years old gentleman presented with retrosternal chest pain for six months. There was no heart murmur. Echocardiogram showed mild anterior hypokinesia; a persantin thallium scan showed partial reversible defect of the distal LAD territory. The patient underwent a coronary angiogram, which revealed a patent arteriovenous fistulae originated from a large first diagonal artery and draining into the pulmonary artery (Figures 1 and 2). This resulted in a distal LAD "steal" with subsequent myocardial ischaemia. The LV ventriculogram revealed a mild anterior hypokinesia.