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Coronary steal with unstable angina secondary to a coronary artery fistula.

BACKGROUND
A 62-year old man with progressive deterioration of stable angina presented with an unstable episode and was referred for diagnostic coronary angiography.


INVESTIGATIONS
Physical examination, electrocardiography, myocardial perfusion scan, coronary angiography, cardiac CT.


DIAGNOSIS
Left coronary main stem to pulmonary artery fistula.


MANAGEMENT
Coronary angiography, percutaneous coronary intervention, coil embolisation.