Left Anterior Descending Artery to Pulmonary Artery Fistula: A Case Report.

This case describes a 59-year-old patient who initially presented with symptoms consistent with stable angina and a subsequent diagnosis of non-ST elevation myocardial infarction with further conversion to an ST-elevation myocardial infarction. A left cardiac catheterization was scheduled to evaluate the patient's acute coronary syndrome. He later developed worsening chest pain and a repeat electrocardiogram (ECG) showed ST elevations in anterolateral leads. The patient was emergently transported to the cardiac catheterization lab. The coronary angiogram revealed a proximal left anterior descending artery (LAD) lesion. During the catheterization, abnormal communication between the LAD and the pulmonary artery was discovered and the patient was diagnosed with a coronary artery fistula. This case presents a unique scenario for an ST-elevation myocardial infarction with an incidental diagnosis of a coronary artery fistula.