A Kaleidoscope heart

In the current manuscript, we report an unusual case of a young 18-year-old woman who survived an out-of-hospital cardiac arrest secondary to Bland-White-Garland syndrome. Her transthoracic echocardiogram showed an abnormal color Doppler flow-pattern within the myocardium indicative of coronary fistulous flow that prompted further evaluation with coronary CT angiography, which confirmed the diagnosis. Our case serves not only as a reminder to consider coronary artery anomalies as a cause of sudden cardiac death in young individuals but also as a prompt to investigate unusual echocardiographic findings with alternative imaging when the diagnosis may not be initially clear.