Two cases of myocardial infarction with coronary arteriovenous fistula.

Myocardial infarction in the presence of coronary arteriovenous fistula (CAVF) has rarely been reported. Two young male patients with dual abnormalities, an organic stenosis and a CAVF in the left anterior descending artery, were reported. Each fistula originated closely proximal to the stenotic lesion and drained into the main pulmonary artery. It was thought that the coronary steal phenomenon through the fistula further reduced the coronary blood flow distal to the stenosis. Thus, both the stenotic lesion and the fistula possibly contributed to the occurrence of the myocardial infarction. Since angiographic details of myocardial infarction with CAVF have rarely been reported these findings may be important in clarifying the mechanism of myocardial infarction with CAVF.