Coronary artery fistulas have a low incidence and are often diagnosed by echocardiography or coronary computed tomography angiography, although coronary angiography is the gold standard. They commonly originate in the right coronary artery, with drainage to low-pressure chambers being the most frequent finding. Treatment can be expectant, surgical, or percutaneous. This report describes a case of a rare presentation of heart failure due to a fistula of the circumflex coronary artery with drainage into the left atrium.
Coronary–Cavitary Fistula of the Circumflex Coronary Artery to the Left Atrium as a Probable Etiology of Heart Failure: A Case Report
CoelloRCA, AndradeVC, VintimillaSAC, Madrini JúniorV, RamirezJFA. Coronary–Cavitary Fistula of the Circumflex Coronary Artery to the Left Atrium as a Probable Etiology of Heart Failure: A Case Report. Arq Bras Cardiol: Imagem cardiovasc 2021;34(4):eabc220.
Coello,Roberto Carlos Alvarez; Andrade,Vitor Coutinho; Vintimilla,Santiago Andrés Castro; Madrini Júnior,Vagner; Ramirez,José Felix Alvarez. Coronary–Cavitary Fistula of the Circumflex Coronary Artery to the Left Atrium as a Probable Etiology of Heart Failure: A Case Report. Arq Bras Cardiol: Imagem cardiovasc, v. 34, n. 4, eabc220, Mar. 2021.
Coello,R.C.A., Andrade,V.C., Vintimilla,S.A.C., Madrini Júnior,V., & Ramirez,J.F.A. (2021). Coronary–Cavitary Fistula of the Circumflex Coronary Artery to the Left Atrium as a Probable Etiology of Heart Failure: A Case Report. Arq Bras Cardiol: Imagem cardiovasc,34(4), eabc220.
Coello,Roberto Carlos Alvarez and Andrade,Vitor Coutinho and Vintimilla,Santiago Andrés Castro and Madrini Júnior,Vagner and Ramirez,José Felix Alvarez. Coronary–Cavitary Fistula of the Circumflex Coronary Artery to the Left Atrium as a Probable Etiology of Heart Failure: A Case Report. Arq Bras Cardiol: Imagem cardiovasc [online]. 2021, vol. 34, n. 4, [cited 2026-03-06], eabc220. Available from: <https://www.abcimaging.org/article/coronary-cavitary-fistula-of-the-circumflex-coronary-artery-to-the-left-atrium-as-a-probable-etiology-of-heart-failure-a-case-report/>. ISSN .
Figure 1
– Coronary angiogram showing left anterior oblique caudal projection (spider). The arrows indicate the ascending branches in a halo communicating with the left atrium.