Abstract
Coronary artery fistulas (CAFs) are rare congenital heart diseases in which there is a communication between a coronary artery and a cardiac chamber or a great vessel. Its diagnosis can be made noninvasively by echocardiography. We report a case of left anterior descending coronary artery (LAD) to right ventricle fistula where the diagnosis was made by 2D and Doppler echocardiography. The fistula was an incidental finding in an asymptomatic 5-year-old child who underwent echocardiography because of a loud cardiac murmur on physical examination. The Doppler study allowed to accurately evaluate the haemodynamic consequences of the fistula. With this case report, we want to highlight how the typical flow pattern of a left coronary artery to RV fistula can be studied by a comprehensive Doppler echocardiography examination. The knowledge of the Doppler appearance in these cases can help to appreciate the pathophysiology of the fistula and to differentiate between other concomitant abnormalities such as muscular ventricular septal defects (VSDs).
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