CTICasesMultiple Congenital Coronary-Cameral Fistulas
Imaging findings
CT coronary angiography shows aneurysmal, tortuous enlargement of all three major coronary arteries (LAD, LCx, and RCA) with multiple, tiny fistulous connections draining directly into the right and left ventricular cavities.
Key takeaways
Coronary-cameral fistulas are congenital anomalies where coronary arteries communicate directly with cardiac chambers. While solitary fistulas are more common, diffuse involvement of all major coronary arteries with multiple micro-fistulas is extremely rare, causing a coronary steal phenomenon and right heart volume overload.
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