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Coronary artery-left ventricular fistulae associated with apical hypertrophic cardiomyopathy

Omer Alyan1, Ozcan Ozeke, Zehra Golbasi

  • 1Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|July 5, 2005
PubMed

Insights

Coronary artery-left ventricular fistulae, a rare anomaly, can cause angina in patients with apical hypertrophic cardiomyopathy. Recognizing this condition is crucial for patients lacking significant coronary atherosclerosis.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Coronary artery anomalies are rare but clinically significant.
  • Apical hypertrophic cardiomyopathy (AHC) is a distinct form of hypertrophic cardiomyopathy.
  • Angina pectoris typically suggests coronary artery disease (CAD).

Observation:

  • A 63-year-old man presented with a 2-year history of angina pectoris.
  • He had no significant coronary atherosclerosis on angiography.
  • The patient was diagnosed with apical hypertrophic cardiomyopathy.

Findings:

  • An unusual case of coronary artery-left ventricular fistulae (CALVF) was identified.
  • This anomaly was associated with apical hypertrophic cardiomyopathy.
  • The fistulae were considered the likely source of the patient's angina.

Implications:

  • CALVF should be considered in the differential diagnosis of angina in patients with AHC.
  • This case highlights the importance of comprehensive diagnostic evaluation beyond standard coronary angiography.
  • Accurate diagnosis of CALVF can guide appropriate management and prevent unnecessary interventions for CAD.

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