Coronary-to-bronchial artery fistula in a patient with angina

Coronary-to-bronchial artery fistulae are the most common found in adulthood and have often been associated with bronchiectasis and other abnormalities of pulmonary parenchyma. In this study we describe an unusual case in which circumflex coronary artery-to-left bronchial artery fistula was associated with the presence of extensive aneurysmatic dilatation of thoracic arteries. <Learning objective: This report deals with the case of a coronary-to-bronchial artery fistula (CAF) as the cause of atypical angina in a patient with normal coronary arteries. The concomitant finding of aneurysmatic dilatation of thoracic arteries controindicated an invasive approach. Medical therapy with vasodilators and anti-anginal drugs was soon started proving to be efficacious in symptoms relief.>.