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Updated: Jun 26, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Multivessel coronary-ventricular fistulae and ischaemia on cardiac MRI

James C Weaver, Jane A McCrohon, David Rees

    International Journal of Cardiology
    |January 27, 2009
    PubMed

    Insights

    Multivessel coronary ventricular fistulae, a rare anomaly, can cause a coronary steal phenomenon. Cardiac MRI confirmed subendocardial ischemia in a patient, validating this rare condition.

    Area of Science:

    • Cardiology
    • Cardiac Imaging
    • Congenital Heart Disease

    Background:

    • Multivessel coronary ventricular fistulae are rare coronary anomalies.
    • Their clinical and hemodynamic significance remains controversial.
    • Potential origins include arterioluminal or arteriosinusoidal connections.

    Observation:

    • A 69-year-old female presented with exertional dyspnea and atypical chest pain.
    • She had multivessel coronary to left ventricular fistulae.
    • Cardiac MRI with adenosine stress was performed for evaluation.

    Findings:

    • The cardiac MRI revealed subendocardial ischemia in multiple coronary territories.
    • This finding confirmed a coronary steal phenomenon.
    • The results highlight the hemodynamic impact of these fistulae.

    Implications:

    • This case underscores the importance of considering coronary ventricular fistulae in patients with unexplained ischemic symptoms.
    • Cardiac MRI with stress is a valuable tool for diagnosing coronary steal.
    • Further research is needed to fully understand the clinical significance and management of these anomalies.

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