We report on a 51-year-old male who developed traumatic ventricular septal defect and coronary artery fistula after an industrial accident involving injury to his chest. The defects were initially haemodynamically non-significant but he progressively developed symptoms of heart failure with associated dilatation of left atrium and ventricle. The ventricular septal defect was diagnosed by echocardiography and the coronary artery fistula was identified by pre-operative angiography. Both defects were surgically repaired more than one year after the injury. A large muscular ventricular septal defect was patched and the coronary artery fistula was closed from within the right ventricle.
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