Coronary arteriography performed in a 42-year-old male patient showed communications from the left anterior descending artery to the right ventricle one month after a myocardial infarction. The area of communication did not correspond to the site of the infarction as established by electrocardiogram and previous angiography. Exactly how the fistula developed in our case remains unknown. Angiogenesis also suggests that myocardial infarction can lead to spontaneous formation of these coronary anomalies.

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