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Case Reports in Cardiology
Volume 2019, Article ID 5956806, 4 pages
Case Report

Coronary Artery Fistula Diagnosed by Echocardiography during NSTEMI: Case Report and Review of Literature

1Cardiology, Department of Life, Health & Environmental Sciences, University of L’Aquila, Italy
2Division of Cardiology, Policlinico Casilino, Rome, Italy

Correspondence should be addressed to Silvio Romano;

Received 12 June 2019; Revised 1 July 2019; Accepted 7 July 2019; Published 14 August 2019

Academic Editor: Hajime Kataoka

Copyright © 2019 Angelo Acitelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Coronary artery fistulas are rare abnormal connections between a coronary artery and a cardiac chamber or a major vessel. Often, they are asymptomatic and the diagnosis is accidental. The case we present is the incidental finding of a fistula displayed with echocardiography during acute coronary syndrome (ACS). A 73-year-old man presented in the emergency room for non-ST-elevation ACS. Echocardiogram showed in a parasternal short axis view an abnormal diastolic flow inside the ventricular inferior wall. Angiography and CT confirmed the diagnosis of coronary fistula from the right coronary into the left ventricular cavity. A literature analysis with discussion about coronary fistulas classification and management was also performed.