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A 77-year-old woman was referred for the evaluation of an abnormal shadow on the left cardiac border on chest x-ray films that had gradually developed over a seven-year period (arrow in Panel A). She had no history of Kawasaki's disease or chest trauma and had no chest symptoms. A loud, continuous murmur could be heard at the upper left parasternal area. A selective left coronary arteriogram (Panel B) revealed a fistula, the middle of which formed an aneurysm measuring 52 by 46 mm. There was also severe stenosis of the left main coronary artery. The fistula originated from the proximal . . . [Full Text of this Article] |
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