Coronary artery fistula (CAF) is a congenital condition characterized by a pathological communication between a coronary artery and a systemic vein or one of the cardiac chambers. Iatrogenic CAFs were reported to develop secondary to the rupture of coronary aneurysm. Instances of acquired CAF draining into the cardiac chambers have been described after acute myocardial infarction. Angiography is the gold standard in diagnosing CAF. We describe the case of a patient who developed a fistula draining into the middle cardiac vein on the posterior interventricular sulcus, after acute myocardial infarction, revealed by CT scan.
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