Right Coronary artery to pulmonary artery fistula

A coronary artery fistula is an abnormal communication between a coronary artery and one of the cardiac chambers or a great vessel, so bypassing the myocardial capillary network. They are usually discovered incidentally upon coronary angiography. Clinical manifestations are variable depending on the type of fistula, the severity of shunt, site of shunt, and presence of other cardiac condition.We report a 75-year-old woman  without any previous medical history cmplaining for atypical chest pain. CT angiography revealed a coronary artery fistula arising from right coronary artery to the main pulmonary artery.