Múltiplas fístulas das artérias coronárias ao ventrículo esquerdo / Multiple Coronary Artery to Left Ventricle Fistulae

A 51 year-old man was admitted to the coronary care unit due an episode of retroestenal pain with ischaemic alterations in electrocardiogram. It was made the diagnosis of unstable angina. Cinecoronariography showed dilated coronary arteries without obstructions and multiples coronary fistulas draining into left ventricular cavity. Transesophagic echocardiogram with microbubbles injection into coronary arteries showed an important coronary steal phenomena. It is discussed the diagnosis and the treatment. This is one of the rare cases of coronary fistulas draining into the left ventricular cavity and the first one with alterations in the rest ECG.