A 57 year old male smoker, with a long history of hypertension, presented with angina. The physical examination was unremarkable. An ECG showed sinus rhythm and T inversion over lateral leads. A coronary angiogram (panel A) showed normal left anterior descending (LAD) and circumflex arteries. An extremely tortuous coronary fistula forming multiple loops was observed. The origin of the fistula from the LAD was not clearly seen from multiple views …