title: Asymptomatic Right Coronary Artery-to-Pulmonary Artery Fistula Incidentally Detected by Transthoracic Echocardiography.
abstract: In this case report, we describe a 71-year-old woman with right conal coronary artery-to-pulmonary trunk fistula. She visited the outpatient clinic of the nephrology department for long-term management of renal dysfunction. On transthoracic echocardiography (TTE) conducted as a part of cardiac evaluation, an abnormal Doppler color flow taking a course toward echocardiographic probe was incidentally detected outside the main pulmonary trunk, giving an impression of congenital coronary arteriovenous (AV) fistula. Computed tomography coronary angiography confirmed the presence of congenital coronary AV fistula from a conal branch of the right coronary artery to the main pulmonary trunk in the form of a ground cherry. Although the direction of Doppler color flow is not usual (i.e. toward, not away from, echocardiographic probe) in this case, congenital coronary AV fistula should be in the first priority among potential diagnoses when an abnormal Doppler color flow was found near the main pulmonary trunk on TTE.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Woo-Hyun
authors.initials: WH
authors.lastname: Lim
authors.forename: Si-Hyuck
authors.initials: SH
authors.lastname: Kang
authors.forename: Kihyun
authors.initials: K
authors.lastname: Jeon
authors.forename: Iksung
authors.initials: I
authors.lastname: Cho
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Sung-Wook
authors.initials: SW
authors.lastname: Hwang
authors.forename: Hyung-Kwan
authors.initials: HK
authors.lastname: Kim
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn