We report the case of a 16-year-old young girl seen for precordial pain and stage II NYHA dyspnea. Clinical examination found a maximal systolodiastolic murmur in the left subclavicular. Lateral Q waves were noted on the electrocardiogram and echocardiography revealed a right coronary fistula draining in right atrium. CT scan confirmed the diagnosis. Patient was addressed to a specialized center for percutaneous closure of the fistula. In case of signs indicating coronary artery disease, the search for coronary anomalies should be systematic in children by using EKG and transthoracic echocardiography. In case of doubt,？a second imaging such as the multislice Ct scan is performed. Coronary angiography has a dual diagnostic and therapeutic interest. The indications for treatment depend on the symptoms and the results of ischemia tests.
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