A CASE OF MULTIPLE CORONARY-ARTERY TO LEFT-VENTRICULAR COMMUNICATIONS

A 39-year-old man with anginal pain had multiple coronary artery to le ft ventricular communications. His electrocardiogram showed evidence o f left ventricular hypertrophy, and an echocardiogram revealed a dilat ed left ventricle. A coronary angiogram revealed multiple coronary art ery to left ventricular fistulae involving three major coronary arteri es with no evidence of atherosclerotic lesions. Only 17 cases of such fistulous communications involving three major coronary arteries have been reported in the literature. It is suggested that the fistulous co mmunications to the left ventricle was a cause of his angina pectoris, probably because of the coronary steal phenomenon.