CORONARY FISTULOUS COMMUNICATIONS WITH LEFT-VENTRICULAR CHAMBER AND GIANT MURAL THROMBUS AFTER MYOCARDIAL-INFARCTION

Selective coronary arteriography, performed in a 67-year-old man with post-infarction angina, demonstrated severe three vessel disease and c oronary fistulous communications with the left ventricular chamber adj acent to a giant mural thrombus formed in the apical aneurysm. Most of the contrast media seemed to empty directly into the chamber without presenting hypervascular blushes of the thrombus itself. This was some what different from the observation previously reported in a case with coronary fistulae associated with a post infarction mural thrombus. I t was stressed that one should not misinterpret this condition as a ra re coronary artery-cardiac chamber shunt associating myocardial infarc tion.