摘要To the editor:A 70-year-old man presented with coronary artery fistula (CAF) for 20 days.He had a history of angina and breathlessness.Comorbidities included right submandibular gland cyst.The patient was undergone elective coronary angiography to confirm the diagnosis.His heart rate was 80 beats/min,the cardiac border enlarged on the left side,and a blast systolic murmur (grade 3/6) could be detected at the second and third ribs on the right side of sternum.And the thrill was noted on the right side of sternum.He had heart function of NYHA 3-class.Routine blood tests and biochemical tests were within normal limits.An electrocardiogram revealed sinus rhythm and T-wave change.Echocardiography revealed the left ventricle enlarged,the ventricular wall not thick.The left and right coronary artery was also found fistulae to the surface of pulmonary artery.A coronary angiogram revealed double coronary artery-pulmonary artery fistulae,and demonstrated multiple coronary arteries to pulmonary artery fistulae originating from the left anterior descending (LAD) and right coronary arteries (RCA) (Figure 1).