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A 49-year-old man presented with progressive exertional dyspnoea associated with palpitations for 4 months’ duration. Physical examination was notable for marked jugular venous distention and a to-and-fro murmur was heard at the apex. A chest x-ray showed significant cardiomegaly with a bulging contour over the right cardiac border (figure 1A). Transthoracic echocardiography revealed the right coronary artery (RCA) was obviously dilated with a huge aneurysm and a fistula draining into the LV, moreover, the right heart chamber was significantly …
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