Large bilateral coronary artery fistulae

We describe a case of impressive/large bilateral coronary artery fistulae in a patient who developed transient symptoms of palpitations during pregnancy. As this woman remained asymptomatic and her haemodynamic reserves during multiple pregnancies had been good, it was decided to apply a conservative approach. Consideration, in certain circumstances, should be given as to closure of these fistulae, in view of the potential to develop pulmonary hypertension as a result of a significant cardiovascular shunt.