"Congenital" Coronary Arteriovenous Malformations: Are They Truly Congenital?

We report a patient with ischemic chest pain due to obstructive coronary artery disease. The patient underwent a second cardiac catheterization 2 years later that revealed progression of the coronary disease and the appearance of a new arteriovenous malformation. Unless a prior angiogram was available, this malformation would have been classified as congenital. This case report raises the question of whether all congenital arteriovenous malformations are truly congenital.