Fistula from right and left coronary arteries to pulmonary artery: Coronary CT angiography and coronary angiography findings

Coronary artery fistula is an abnormal communication between the coronary artery and either the cardiac chamber or the great vessel. In particular, the coronary-to-pulmonary artery fistula can be supplied by either one or both coronary arteries and drains to the pulmonary trunk. We report a unique case of fistula originating from both coronary arteries and draining into both sinuses of the main pulmonary artery in a 57-year-old female who experienced chronic chest pain and palpitation. Dilated and tortuous fistulas were found in coronary angiography and coronary computed tomography angiography examinations. To aid early diagnosis and clinical management, radiologists should be aware of the characteristic radiologic findings.