CTICasesLarge Coronary Artery Fistula from RCA to Right Atrium (Follow-up)
Imaging findings
Follow-up coronary CT confirms a very large, tortuous proximal right coronary artery (RCA) that drains into the right atrium, consistent with a large coronary artery fistula. The previously noted "mass" on MRI was a filling defect caused by dephasing from turbulent flow within the right atrium due to the shunt.
Key takeaways
This case demonstrates the correlation between MRI findings (initially mistaken for a right atrial mass due to flow dephasing) and definitive CT angiography, confirming a large coronary artery fistula from the RCA to the right atrium. It emphasizes how turbulent flow can mimic structural abnormalities on MRI and the importance of multi-modality imaging.
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