Vascular Malformation Overlying the Pulmonary Artery

T HE PRESENCE of an asymptomatic patent ductus arteriosus is usually suspected on the basis of auscultatory findings, and the diagnosis is supported by electrocardiography and roentgenography. Other vascular and cardiac lesions that produce continuous murmurs to the left of the upper sternum are usually symptomatic and are associated with additional changes requiring cardiac catheterization and contrast studies for a final diagnosis. Aneurysmal dilatation of the coronary vessels associated with arteriovenous fistulas give rise to murmurs simulating patent ductus arteriosus. These anomalies may be entirely asymptomatic or cause the symptoms of myocardial ischemia. The following is a case report of a coronary-pulmonary artery fistula not involving the myocardium and simulating a patent ductus arteriosus.