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\begin{document}

\title{A cystic structure in right atrium as a hint of coronary artery fistula}



\author[1]{Amirhossein Niknazar}%
\author[2]{mahboubeh pazoki}%
\author[3]{Seyed  Sezavar}%
\author[2]{pegah Joghataie}%
\author[4]{Hamidreza Pouraliakbar}%
\affil[1]{Tehran University of Medical Sciences School of Medicine}%
\affil[2]{Hazrat-e Rasool General Hospital}%
\affil[3]{Iran University of Medical Sciences}%
\affil[4]{Rajaie Cardiovascular Medical and Research Center}%


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  \date{May 13, 2024}


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\begin{abstract}
Coronary artery fistula is a rare cardiac disease which could be
diagnosed by multiple imaging modalities and could be effectively
treated by surgical or percutaneous closure. The patient is a 21 years
old man initially presented with palpitation and paroxysmal atrial
fibrillation. For further evaluation he underwent transthoracic
echocardiography on which a mass like structure was found in right
atrium. On transesophageal echocardiography this cystic structure was in
continuation with dilated left circumflex coronary artery and based on
data from both CT angiography and coronary angiography , coronary artery
fistula with abnormal drainage right atrium was defined and percutaneous
closure was proposed. Learning objective: As coronary artery fistula is
a rare condition, making the acquaintance of its clinical presentation,
the role of imaging modalities in diagnosis and therapeutic options is
our concern. In this patient paroxysmal atrial fibrillation and then a
cystic mass like structure in right atrium led us to the diagnosis in
stepwise approach.%
\end{abstract}%



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