BMJ Case Reports 2017; doi:10.1136/bcr-2017-220424
  • Images in…

Unusual presentation of right coronary artery fistula

  1. Gerry P McCann1
  1. 1University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2Suez Canal University, Ismailia, Egypt
  1. Correspondence to Dr Ahmed MSEK Abdelaty, amsek1{at}
  • Accepted 19 April 2017
  • Published 12 May 2017


A female aged 70 years, with no previous comorbidities, was referred with suspected heart failure due to mild exertional dyspnoea, mildly elevated brain-natriuretic peptide (BNP) (139 ng/L) and inferolateral T-inversion on ECG. A transthoracic echocardiogram (TTE) showed a moderate global pericardial effusion, mild left ventricular hypertrophy (LVH), moderate aortic stenosis (AS) and preserved systolic function. Serial TTE’s showed a resolving pericardial effusion, moderate left ventricular hypertrophy (LVH) and bi-atrial dilatation, following which cardiac magnetic resonance imaging (CMR) was requested to exclude infiltrative cardiomyopathy. An angiogram was also requested due to suspicion of moderate-to-severe AS, as a work-up for future valve replacement. CMR showed a severely …

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article