Abstract
A 75-year-old male with asymptomatic left coronary cameral fistula and left coronary artery aneurysm of the circumflex branch complained about chest discomfort on exertion after six months from the initial diagnosis. The stressed myocardial scintigraphy demonstrated induced ischemia in the left circumflex territory. The coronary angiogram revealed triple-vessels disease in addition to the aneurysm and the fistula. The patient subsequently underwent triple coronary artery bypass grafting and obliteration of the coronary artery fistula. The patient’s symptoms disappeared. Even asymptomatic coronary artery fistula, with the patient being elderly and having coronary risk factors, may cause changes in symptoms and cardiac function. Functional assessment by myocardial scintigraphy in addition to the coronary angiography and multidetector-row computed tomography was useful to determine the appropriate treatment and timing of intervention.
