Coronary artery fistula with anomalous coronary artery origin: a case report.

Congenital anomalies of the coronary arteries occur in 0.2% to 1.2% of the general population. Most coronary artery anomalies are found incidentally during angiographic evaluation for other cardiac diseases. We describe the case of a young woman presenting with chest discomfort and fatigue where echocardiography identified a coronary artery fistula. Successful embolization of the coronary artery fistula was performed. To our knowledge, this is a unique case of an anomalous coronary artery and a fistulous anomaly in the same patient. This report describes the echocardiographic diagnosis, and the feasibility of a transcatheter management decision to avoid cardiopulmonary bypass in a patient in whom blood products are contraindicated.