Coronary arterial fistula is a rare defect characterized by a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. Complications include 'steal' from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrillation, rupture, endocarditis/endarteritis and arrhythmias.Here we report the case of a 73-year-old female that was admitted for unstable angina. Coronary angiography revealed the presence of multiple large coronary-cameral fistula. CT scan confirmed the presence of ecstasis of the left main artery, associated with coronary-cameral fistulae between left ventricle and ramus intermedius artery and the circumflex artery.