Coronary to pulmonary artery fistulae (CAF) are rare cardiac anomalies. The majority arise from the right coronary artery, with fistulae originating from the left anterior descending artery or from multiple arteries being less common. CAF are frequently asymptomatic and found incidentally on routine cardiac imaging. We present the case of a 61-year-old woman with multiple CAF who presented with progressive shortness of breath and chest pain and was ultimately treated successfully with trans-catheter coiling with marked improvement in symptoms. We also review the currently available literature regarding advances in diagnosis and treatment of CAF.