Acquired coronary artery fistula from nonpenetrating chest injury.

An anterior myocardial contusion resulted from a nonpenetrating chest injury. A continuous murmur was detected four years later, and a left anterior descending coronary artery to right ventricular fistula was surgically ligated twice, with recurrence of the fistula three months after the initial ligation. Six previous traumatic coronary artery fistulas have been reported, all secondary to penetrating chest trauma.