Sinoatrial Nodal Artery Fistula to Left Atrium
Imaging findings
CT coronary angiography shows marked, tortuous dilation of the sinoatrial (SA) nodal branch arising from the right coronary artery, which is seen communicating directly with the left atrium, representing a coronary-cameral fistula.
Key takeaways
Coronary-cameral fistulas are vascular anomalies where coronary artery branches drain directly into a cardiac chamber. A fistula involving the SA nodal artery is rare, presenting as a tortuous, dilated atrial branch that can create a left-to-right shunt and trigger atrial arrhythmias.
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