A tortuous road for septic pulmonary emboli in left-sided endocarditis.

Coronary artery fistulae are rare congenital or acquired connections between the coronary vessels and the cardiac chambers or other vascular structures. We report a case of a woman with mitral valve endocarditis and multiple pulmonary septic emboli. Transesophageal echocardiography revealed a tortuous coronary fistula as the pathway for the septic emboli. The fistula, which originated from the right coronary artery to the right atrium, was visualized using different imaging modalities.