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Echocardiographic diagnosis of a right coronary artery-coronary sinus fistula

Remzi Yilmaz1, Recep Demirbag, Mustafa Gur

  • 1The Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey. drremziyilmaz@yahoo.com

The International Journal of Cardiovascular Imaging
|December 3, 2005
PubMed

Insights

A rare right coronary artery-coronary sinus fistula caused chest pain and ventricular tachycardia in a 67-year-old woman. Echocardiography and cardiac catheterization confirmed the diagnosis, highlighting imaging

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Coronary artery anomalies are rare but can lead to significant cardiovascular events.
  • Right coronary artery-coronary sinus fistula is an uncommon type of coronary artery fistula.

Observation:

  • A 67-year-old woman presented with chest pain, ischemic electrocardiogram (ECG) changes, and ventricular tachycardia.
  • Transthoracic echocardiography revealed a dilated coronary sinus and enlarged right coronary artery.
  • Transesophageal echocardiography with color flow mapping demonstrated the fistula and Doppler confirmed a significant pressure gradient.

Findings:

  • Cardiac catheterization confirmed the diagnosis of a right coronary artery-coronary sinus fistula.
  • The fistula drained the right coronary artery into the coronary sinus, creating a 94 mmHg peak gradient.

Implications:

  • Transthoracic and transesophageal echocardiography are effective diagnostic tools for identifying coronary artery fistulas.
  • Early and accurate diagnosis of coronary artery-coronary sinus fistula is crucial for appropriate management and prevention of complications.

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