Coronary Artery Fistula Causing Angina

Coronary artery fistula is a rare congenital coronary artery anomaly, but it can cause typical chest pain in the setting without significant coronary artery stenosis. Herein, we demonstrated a case of coronary artery fistula with abnormal 201thallium perfusion scan-steal phenomenon. She presented with typical chest pain, but the coronary angiography only revealed a coronary artery fistula drained into pulmonary artery. In the meanwhile, the coronary artery is patent. This case reminds the clinicians coronary artery fistula should be considered as one of the differential diagnosis of chest pain.