Incidental Finding of a Right Coronary Artery to Coronary Sinus Fistula in an Adult Transthoracic Echocardiogram

Abstract

Congenital coronary artery fistula (CAF) is a rare anomaly of the heart presenting in 0.002% of the general population. This case study presents an adult patient with an undiagnosed heart murmur and symptoms of chest pain, fatigue, and lightheadedness that demonstrated an incidental finding of CAF diagnosed by transthoracic echocardiography. Transthoracic echocardiography revealed an aneurysmal, tortuous right coronary artery terminating in a dilated coronary sinus. Sonographic findings were compared with angiography and computed tomography. This study highlights the potential of transthoracic echocardiography to assess heart structure and physiology and detect a CAF.