Genesis of a coronary‐cameral fistula

Coronary artery fistulae are a rare congenital abnormality. If such fistulae drain directly into a cardiac chamber, they are termed coronary‐cameral fistulae. Such fistulae are usually congenital in origin or, occasionally, may arise as an iatrogenic complication of a cardiac procedure such as cardiac catheterization or surgery. We present a highly unusual case in which a patient presented to cardiac services on two occasions—nearly a decade apart—and was found to have coronary aneurysms initially, the largest of which expanded further and into the right atrium, thus creating a coronary‐cameral fistula.