Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes be totally asymptomatic and can be found incidentally during coronary arteriography later in adult life. We report the case of a 75-year-old man with such a fistula and describe our diagnostic approach. In addition, we review the literature on the etiology, epidemiology, the diagnostic modalities and treatment of coronary fistulas.

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