A case of right coronary artery to left ventricle fistula: two-dimensional echocardiographic study.

A 12-year-old boy with a decrescendo diastolic murmur maximal at the lower right sternal border was suspected of having a coronary arteriovenous fistula. Cardiac catheterization and angiography revealed a right coronary artery to left ventricle fistula with marked dilatation of the right coronary artery. This is the thirteenth case of this anomaly reported in the literature. Characteristic two-dimensional echocardiographic features of this case are presented. A markedly dilated right coronary artery was revealed by two-dimensional echocardiography to take a normal right coronary artery course and empty into the posteromedial portion of the left ventricle. This case indicates the possibility of visualizing a dilated peripheral portion of the right coronary artery using two-dimensional echocardiography.