[Phonocardiographic and ultrasonocardiographic findings in seven cases of coronary artery fistula (author's transl)].

The diagnosis possibility of the involved arteries as well as drained site was studied in 7 cases of coronary artery fistula by pharmacodynamic phonocardiography and echocardiography. All cases had a continuous murmur, which was decreased soon after the inhalation of amyl nitrite but increased thereafter. These characteristic changes were diagnostic for coronary artery fistula. Two-dimensional echocardiograms could easily disclose the fistulous coronary artery with proximal dilatation, but not that without dilatation. The 2.4 and 3.5 mHz transducer used in this study revealed the fistulous coronary artery of 5 mm diameter confirmed by the angiocardiogram. However, the visualization depended on the anatomical relation to the aorta. In cases with drainage into the pulmonary artery, the fistulous coronary artery passed usually upwards near the aorta, so that it could be detected with the beam direction focussing to the anterior and posterior walls of the aorta. In these cases, the passage of the fistulous artery originating from the right coronary artery was easily recognized and the involved coronary artery was inferred. But it was difficult to follow the passage when originating from the left coronary artery.