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Congenital coronary arteriovenous fistula presenting with syncope

D S Braden1, K R O'Neal, M R McMullan

  • 1Division of Pediatric Cardiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.

Pediatric Cardiology
|March 13, 2002
PubMed

Insights

Syncope in patients with coronary arteriovenous fistula (CAVF) is often linked to coronary steal. This case report details syncope in a young woman with CAVF, occurring without the typical coronary steal mechanism.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Medical Case Reports

Background:

  • Coronary arteriovenous fistula (CAVF) is a rare congenital or acquired anomaly.
  • Syncope is a potential symptom in patients with CAVF, previously attributed to coronary steal.
  • Coronary steal describes a phenomenon where blood is diverted from the myocardium.

Observation:

  • A young woman presented with recurrent episodes of syncope.
  • The patient was diagnosed with a coronary arteriovenous fistula (CAVF).
  • Diagnostic imaging revealed no anatomical basis for a coronary steal phenomenon.

Findings:

  • The patient experienced syncope despite the absence of a coronary steal mechanism.
  • This challenges the established theory linking syncope in CAVF solely to coronary steal.
  • Suggests alternative pathophysiological mechanisms for syncope in CAVF.

Implications:

  • Re-evaluation of the pathophysiology of syncope in coronary arteriovenous fistula is warranted.
  • Clinicians should consider alternative causes of syncope in CAVF patients without coronary steal.
  • Further research is needed to elucidate the exact mechanisms causing syncope in such cases.

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