Myocardial ischemia due to the left anterior descending -pulmonary artery fistula

Coronary–pulmonary artery fistula is a rare anomaly. They are usually congenital, but also may be acquired. Its real prevalence is unknown, as the majority of patients remain asymptomatic. Depending on the size and location of the fistula, it can cause ischemic symptoms, the so-called ‘coronary steal phenomenon’. We reported a case of a coronary–pulmonary artery fistula with ischemia in a 56 year-old woman. We also discussed the importance of recognizing congenital anomalies in the population, the special features and management of treatment.