Abstract
Summary The pathogenesis of coronary artery ectasia (CAE) is not fully understood and associated with a vast group of disorders. We present a rare case of CAE of the left coronary artery associated with microfi stulae. Microfi stulae bypass myocardial capillaries and decrease the distal blood fl ow. The coronary artery responds to this coronary steal phenomenon with a compensatory dilatation, causing diff use ectasia to catch up for the considerable decrease in coronary diastolic perfusion pressure. Although segmental dilatation is frequently seen in association with hypertension, one should think of microfi stulae as an underlying cause of diff use coronary ectasia.
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