Abstract

A 45 years old man with a history of non-ST elevation Acute Coronary Syndrome was found to have a double coronary cameral fistula originating from the first diagonal artery and the proximal segment of the right coronary artery, with both arteries entering the left atrium. There was no evidence of coronary stenosis and no regional wall motion abnormality from baseline echocardiography. Exercise Stress Echocardiography was performed using an upright ergocycle and the result is indicated an ischemic response in the right coronary artery territory.