A 68-year-old man presented with history of postprandial angina for 6 months. He was a diabetic and hypertensive for 10 years. He was also a reformed smoker with 20 pack-years history of smoking. He did not give any history of acute coronary syndrome or any cardiac catheterisation. Clinical examination was unremarkable. ECG and chest X-ray were normal. Echocardiography revealed normal left ventricular function with features of left ventricular hypertrophy.
Coronary angiography revealed abnormal spillage of contrast in the left ventricular apical region with each diastole from obtuse marginal (OM) branch of left circumflex coronary artery (LCx) and distal part of left anterior descending coronary artery (LAD) suggestive of coronary–cameral fistula (CCMF) (figure 1, figure 2, online ). Coronary angiography did not show any signs of atherosclerotic coronary artery disease. Absence of dilated communicative fistulous tracts between the coronary arteries and the drainage chamber was...
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