Thebesian vein Combined with Apical Hypertrophic Cardiomyopathy

A 52-year-old woman presented with atypical chest pain. Coronary angiography demonstrated multiple microfistulae between left coronary artery and left ventricle (LV) cavity, extensive enough to produce an LV angiogram. This LV angiogram revealed apical hypertrophic cardiomyopathy (HCM) which was confirmed by echocardiography. Coronary steal phenomenon by coronary artery microfistulae and HCM might have a role for developing of angina in patient with apical HCM.