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Coronary artery fistulas: CT findings

Navid A Zenooz1, Reza Habibi, Leena Mammen

  • 1Department of Radiology, Yale New Haven Hospital, 20 York St, New Haven, CT 06510, USA. navid.zenooz@yale.edu

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|May 19, 2009
PubMed

Insights

Coronary artery fistulas, often found incidentally, can cause serious symptoms like heart failure. Early diagnosis via CT angiography and conventional angiography is crucial for timely intervention and preventing complications.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Coronary artery fistulas are uncommon congenital abnormalities where coronary arteries connect abnormally.
  • While often asymptomatic and incidentally discovered, they can lead to significant clinical issues such as chest pain and heart failure, particularly in younger individuals.
  • Prompt diagnosis and intervention are vital due to the risk of late-onset symptoms and complications.

Purpose of the Study:

  • To highlight the increasing incidental detection of coronary artery fistulas with advanced imaging techniques.
  • To emphasize the importance of recognizing these anomalies for timely management.
  • To discuss the diagnostic roles of computed tomography (CT) angiography and conventional angiography.

Main Methods:

  • Review of cases where coronary artery fistulas were identified.
  • Comparison of diagnostic capabilities of 64-row multi-detector computed tomography (CT) angiography versus conventional angiography.
  • Emphasis on careful examination of coronary artery anatomy during cardiac CT scans.

Main Results:

  • The prevalence of incidentally detected coronary artery fistulas is rising with the increased use of multi-detector CT.
  • CT angiography offers significant value in identifying these anomalies.
  • Both CT angiography and conventional angiography can provide complementary diagnostic information.

Conclusions:

  • Coronary artery fistulas require vigilant detection due to potential severe clinical manifestations.
  • Computed tomography (CT) angiography is increasingly important for the incidental diagnosis of coronary artery fistulas.
  • A combination of imaging modalities may offer additive diagnostic value, underscoring the need for meticulous review of coronary artery anatomy in all cardiac CT studies.

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