A case of coronary artery fistula detected by multidetector computed tomography

A 20-year-old man presented with a complaint of easy fatigability. He had no history of angina, trauma, or previous surgery. A continuous cardiac murmur was heard at the level of the fourth intercostal space on the left parasternal border. A left axis deviation was seen on his electrocardiogram. Transthoracic echocardiography was normal. Multidetector computed tomography revealed a fistulous connection between the circumflex artery and the superior vena cava with a diameter of 2.4 mm. The presence of the coronary artery fistula was confirmed angiographically. Since there was no history of trauma or surgery, the fistula was considered congenital. The patient’s symptoms were not directly related to the coronary fistula, and he was discharged for close follow-up.