A case of internal mammary artery-to-pulmonary artery fistula is presented, and all previously reported cases are reviewed. This represents a rare cause of a continuous precordial murmur that may be confused clinically with a patent ductus arteriosus. Patients are usually asymptomatic, and routine diagnostic tests may be of little help in establishing a diagnosis. Selective internal mammary angiography is the procedure of choice for confirmation and localization. The question of advisability of surgery for these patients remains unanswered.
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