[Two cases of coronary artery-left ventricular fistula associated with left ventricular hypertrophy]

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Medical Case Reports

Background:

• Coronary artery-left ventricular fistula (AVF) is a rare congenital or acquired cardiovascular anomaly.
• Left ventricular hypertrophy (LVH) is often associated with conditions causing increased cardiac workload or pressure overload.
• The simultaneous occurrence of AVF and LVH warrants investigation into potential associations.

Observation:

• Two male patients, aged 53 and 46, presented with chest pain and electrocardiographic (ECG) abnormalities, respectively.
• Selective coronary angiography (CAG) in both cases demonstrated bilateral coronary arteries draining directly into the left ventricle (LV).
• ECG revealed ST depression and inverted T waves, while two-dimensional echocardiography indicated hypertrophic cardiomyopathy (HCM) in both individuals.

Findings:

• The study identified two distinct cases of coronary artery-left ventricular fistula.
• Both patients exhibited left ventricular hypertrophy, diagnosed as hypertrophic cardiomyopathy (HCM).
• Coronary angiography confirmed the anomalous drainage of bilateral coronary arteries into the left ventricle via intricate vascular networks.

Implications:

• The findings highlight the importance of considering coronary artery-left ventricular fistula in patients presenting with unexplained left ventricular hypertrophy and ECG changes.
• The coexistence of AVF and HCM in these cases suggests a potential, albeit likely casual, association that requires further research.
• Accurate diagnosis through coronary angiography and echocardiography is crucial for managing these rare cardiovascular conditions.