Korean Circ J.  2012 Mar;42(3):205-207. 10.4070/kcj.2012.42.3.205.

Contrast Echo-A Simple Diagnostic Tool for a Coronary Artery Fistula

  • 1Cardiology Division, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. drpuooh@hanmail.net
  • 2Cardiology Division, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.


Coronary artery fistulas have been diagnosed with aortography, coronary angiography, and coronary computed tomography (CT). A large fistula can be occasionally found as a mass lesion on echocardiography but cannot be easily confirmed. Here, we report a new diagnostic approach to coronary artery fistulas using a contrast agent and transthoracic echocardiography. Transthoracic echocardiography of a 46-year-old female suffering from dyspnea revealed suspicious small turbulent flow in the main pulmonary artery. Following infusion of a contrast agent, we found whitish flow in the main pulmonary artery during the diastolic phase, and aortic CT revealed two huge right coronary artery fistulas in the main pulmonary artery. A simple diagnostic approach to a coronary artery fistula using contrast agent helped us confirm the diagnosis because of the typical diastolic whitish flow in the pulmonary artery.


Coronary artery fistula; Echocardiography; Contrast agent
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