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Updated: Apr 6, 2026
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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
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Symptomatic Coronary Cameral Fistula
Prashant Nagpal1, Ashish Khandelwal2, Sachin S Saboo3
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA ; Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Summary
A rare coronary cameral fistula, an abnormal connection between a coronary artery and heart chamber, caused anginal chest pain in a 45-year-old man. Surgical closure resolved his symptoms, highlighting fistula management.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Diagnostic Imaging
Background:
- Coronary cameral fistula is a rare congenital anomaly involving abnormal communication between a coronary artery and a cardiac chamber.
- While often asymptomatic and congenital, symptomatic cases typically manifest in childhood.
Observation:
- A 45-year-old male presented with a year of anginal chest pain and exertional dyspnea.
- Exercise treadmill testing revealed ischemic changes, prompting ECG-gated contrast-enhanced CT.
- CT identified a large right coronary artery to right atrium fistula as the cause of symptoms.
Findings:
- The CT scan definitively diagnosed a right coronary artery to right atrium fistula.
- Coronary atherosclerosis was excluded as the cause of the patient's ischemic symptoms.
- Surgical intervention successfully closed the fistula.
Implications:
- This case underscores that coronary cameral fistulas can present with symptoms in adulthood.
- Successful surgical management of coronary cameral fistulas can lead to complete symptom resolution.
- Diagnostic imaging, particularly CT, plays a crucial role in identifying these rare anomalies.
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