Three-vessel left-ventricular microfistulization syndrome: a rare case of angina

A 55-year-old woman with angina was found to have multiple fistulae from all three major coronary arteries to the left ventricle. The aortography mimicked a severe aortic insufficiency. This rare vascular anomaly can cause a coronary steal phenomenon and subsequent myocardial ischemia in patients without angiographic evidence of major atherosclerotic coronary artery disease.