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Right coronary fistula and aneurysm draining to the right atrium


Erkki Pesonen, M.D., Pediatric Cardiology, Lund University Hospital, SE-22185 Lund, Sweden.
Tel: +46-46-178-280 |
Fax: +46-46-177-051 |


In a 3-year-old boy, a continuous heart murmur was heard. The echocardiogram showed a dilated right coronary artery suggesting the existence of a coronary fistula. A more detailed echocardiogram when the patient was sedated revealed a fistula leading to a large aneurysm and further to the right atrium. The accidental dissection and thrombosis during the interventional heart catheterization resulted in a closure of the fistula. A continuous heart murmur and a dilated coronary artery are the hallmarks of coronary fistula.

Conclusion:  Anatomic details of coronary fistula might be possible to see in an echocardiogram. Interventional heart catheterization is usually an adequate treatment option.