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Localized bronchiectasis is a definite association of coronaro-bronchial artery fistula
Man-Hong Jim1, Stephen Wai-luen Lee, Linda Lam
1Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong. jimmanh2002@yahoo.com
Insights
An incidental coronary artery fistula was found in an 81-year-old smoker with acute coronary syndrome. This rare coronary artery anomaly was associated with localized bronchiectasis, though its cause remains debated.
Area of Science:
- Cardiology
- Thoracic Surgery
- Radiology
Background:
- Coronary artery fistulas are rare congenital or acquired abnormalities.
- Their association with bronchiectasis is documented, but the exact pathophysiology is unclear.
Observation:
- An 81-year-old male smoker with acute coronary syndrome was incidentally found to have a coronaro-bronchial artery fistula arising from the left circumflex artery.
- Percutaneous coronary intervention was performed for severe double-vessel disease.
- High-resolution computed tomography revealed mild bronchiectasis in the lung area supplied by the fistula.
Findings:
- The patient had normal lung function and no respiratory symptoms.
- A definite association exists between coronaro-bronchial artery fistulas and localized bronchiectasis.
Implications:
- This case highlights the importance of recognizing incidental coronary artery anomalies during cardiac investigations.
- Further research into the pathophysiology of coronaro-bronchial artery fistulas and their link to bronchiectasis is warranted.
- Understanding this association may influence future diagnostic and management strategies for patients with similar findings.
Abstract:
An 81-year-old smoker presented with acute coronary syndrome. Coronary angiography revealed severe double-vessel disease, as well as the incidental finding of a coronaro-bronchial artery fistula that arose from the left circumflex artery. Percutaneous coronary intervention was performed on the culprit lesion in the left anterior descending artery. A subsequent high-resolution computed tomography of the thorax revealed mild bronchiectic change in the corresponding area supplied by the coronaro-bronchial artery fistula. The patient had a normal lung function test and never had any chest symptoms. From the literature, the association of the coronaro-bronchial artery fistula and localized bronchiectasis is very definite, but the pathophysiology is still controversial.