Penetrating injury of the chest and coronary arteriovenous fistula.

An unusual case of coronary artery fistula, due to a stab wound in the chest in a 17-year-old male patient, with a resultant acute inferior myocardial infarction is presented. At surgery, complete transection of the right coronary artery was found, which formed a fistulous communication with both the right atrium and the right ventricle. The development of a continuous murmur in the period immediately after the injury, the absence of hemopericardium, and multiple cardiac-chamber involvements were unique features of the case. The inferior myocardial wall was akinetic due to infarction and did not improve following revascularization surgery. A brief review of the literature is also presented.