title: Coronary artery to pulmonary artery fistula.
abstract: METHODS
  Male, 69 FINAL DIAGNOSIS: Coronary artery to pulmonary artery fistula Symptoms: Chest pain Medication: - Clinical Procedure: Echocardiography • angiography • surgical intervention Specialty: Cardiology • Cardiac Surgery.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  A coronary artery fistula is an abnormal communication between a coronary artery and one of the cardiac chambers or a great vessel, so bypassing the myocardial capillary network. They are usually discovered incidentally upon coronary angiography. Clinical manifestations are variable depending on the type of fistula, the severity of shunt, site of shunt, and presence of other cardiac condition.
  
  
  METHODS
  We report a 69-year-old man without any previous medical history, who was admitted to our hospital with chest pain. The electrocardiogram (ECG) showed a sinus rhythm with ST depression in V2 to V6 precordial leads. Coronary angiography revealed a coronary artery fistula from left anterior descending coronary artery (LAD) to the main pulmonary artery, right coronary artery blockage and significant stenoses on the LAD and left circumflex artery (LCX).
  
  
  CONCLUSIONS
  Surgical treatment was chosen because of the total occlusion of the right coronary artery and to relieve of pain to improve quality of life.
authors.affiliation: Department of Cardiology, Dr. Heshmet Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Heidar
authors.initials: H
authors.lastname: Dadkhah-Tirani
authors.forename: Arsalan
authors.initials: A
authors.lastname: Salari
authors.forename: Shora
authors.initials: S
authors.lastname: Shafighnia
authors.forename: Seyed Fazel
authors.initials: SF
authors.lastname: Hosseini
authors.forename: Misa
authors.initials: M
authors.lastname: Naghdipoor
keywords: angiography; coronary artery; electrocardiogram; fistula; left anterior descending coronary artery; left circumflex artery; pulmonary artery