Case report of coronary artery fistula: Added value of multimodal advanced imaging with cardiac computed tomography and cardiac magnetic resonance

RATIONALE: Unlike invasive coronary angiography and echocardiography, cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) imaging allow a coronary artery fistula (CAF) comprehensive evaluation focusing on both coronary and myocardial findings. PATIENT CONCERNS: We present the case of an asymptomatic patient suspected for CAF and referred to our structure for cardiovascular evaluation. DIAGNOSIS: The patient was diagnosed a CAF without coronary artery disease on the basis of CMR and CCT. INTERVENTIONS: The patient underwent an invasive coronary angiography after which the medical staff decided not to surgically treat the CAF. Therefore, a conservative treatment was chosen with strict temporal monitoring. OUTCOMES: After less than 1 year follow-up, the patient presented stable conditions without complaints. LESSONS: Multimodal non-invasive imaging has a key role in patient assessment for disease diagnosis providing better understanding for prognosis and treatment.