A Rare Cardiac Complication of Chest Trauma: Right Coronary Artery – Right Atrium Fistula in a Teenager

Abstract

This report describes a 19-year-old male who sustained multiple chest stab wounds during a house party altercation, resulting in traumatic injury to the right coronary artery (RCA) and a fistula to the right atrium (RA). Coronary angiography showed RCA dilation with communication to the RA, coronary sinus, and right ventricle (RV), while cardiac computed tomography (CT) angiography identified an RCA pseudoaneurysm with an RA fistula, confirmed intraoperatively. The patient was stabilized and underwent successful open-heart surgery involving RCA ligation and coronary artery bypass grafting (CABG). This case emphasizes diagnostic challenges and surgical management of traumatic RCA pseudoaneurysm with fistulous communication.