Diagnosis of the left circumflex coronary artery fistula drainage into the left ventricle by echocardiographic color Doppler flow imaging.

Congenital coronary fistula is consisted of a communication between a coronary artery and a cardiac chamber or pulmonary vessel. Congenital left coronary artery-left ventricle fistula is uncommon. A 41-year-old female patient admitted to our institution for evaluation of heart murmur etiology. A loud continuous murmur heard at the apex area was detected at auscultation. Echocardiography showed a large fistula draining into the left ventricle apex. Coronary angiography revealed fistula from left circumflex coronary artery to left ventricular cavity. Since the patient was asymptomatic and no concomitant cardiac pathology was detected, we advised endocarditis prophylaxis and medical follow-up.