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Diffuse multiple coronary arteries to left ventricular fistulas
Insights
Coronary artery to left ventricle fistula is a rare anomaly. This case details diffuse multiple fistulas in a 60-year-old woman presenting with exertional angina due to myocardial ischemia.
Area of Science:
- Cardiology
- Anatomic Pathology
- Medical Imaging
Background:
- Coronary artery to left ventricle fistula is a rare congenital or acquired anomaly.
- Multiple diffuse fistulas involving both coronary arteries are exceptionally rare.
Observation:
- A 60-year-old woman presented with exertional angina and myocardial ischemia.
- Diagnostic workup revealed diffuse multiple fistulas between both coronary arteries and the left ventricle.
Findings:
- The patient's symptoms were attributed to the coronary "steal" phenomenon.
- Positive stress exercise test confirmed myocardial ischemia.
Implications:
- This case highlights the importance of considering rare fistulas in patients with unexplained angina.
- Understanding the coronary steal phenomenon is crucial for managing such anomalies.
Abstract:
Coronary artery to left ventricular fistula is an unusual anatomic anomaly consisting of a communication between one of the coronary arteries and the left ventricle. Only sporadic cases have been published in the literature. Diffuse multiple fistulas involving both left and right coronary arteries are even rarer. This report describes a 60-year-old woman with diffuse multiple fistulas communicating between both coronary arteries and the left ventricle. The patient manifested clinically with exertional angina and myocardial ischemia, as evidenced by a positive stress exercise test, which represents the coronary "steal" phenomenon.