Pulsed Doppler echocardiographic detection of coronary artery to right ventricle fistula.

The pulsed Doppler echocardiographic (PDE) findings in a case of coronary artery right ventricle fistula are described. The PDE examination revealed normal flow patterns within the right atrium, pulmonary artery, and left ventricle, thus excluding these structures as the distal site of the fistula. Sampling within the right ventricular inflow revealed a turbulent, continuous, systolic-diastolic flow pattern that suggested the right ventricle was the distal end of the fistula. Postoperatively, the PDE examination of the right ventricle reverted to a normal, nonturbulent, phasic flow pattern. We conclude that PDE may be a useful noninvasive method of defining the site of drainage in cases of coronary artery fistula.