Chest radiographs (A and B) from a 63-year-old asymptomatic woman with a loud continuous cardiac murmur over the mid–left parasternal area demonstrate two anteriorly located, round, calcified paracardiac masses (arrows) along the courses of the coronary arteries, measuring 52 mm (a1) and 35 mm (a2) in diameter, respectively. Mild cardiomegaly is also noted. A selective right coronary arteriogram (C) reveals that the right-side mass (a2) is a giant aneurysm of a congenital coronary arteriovenous fistula arising from the right coronary artery (RCA). A selective left coronary arteriogram (D) confirms that the left-side mass (a1) is a giant aneurysm of a congenital coronary arteriovenous fistula arising from a branch of the left anterior descending coronary artery (LAD). Both congenital coronary arteriovenous fistulas drain into the pulmonary trunk (PT). CX indicates circumflex coronary artery.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC 4-265, Houston, TX 77030.
- Copyright © 1997 by American Heart Association