Aortic Regurgitation and Coronary Microfistulae: Double Jeopardy Causing Myonecrosis

We describe a 3-case series of patients with a rare combination of mild-to-moderate aortic regurgitation and coronary microfistulae but nonobstructed epicardial coronary arteries who presented with symptoms of unstable angina and had confirmed myonecrosis. A plausible pathophysiological mechanism for this phenomenon and its clinical implication are discussed.

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