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Multiple coronary artery-left ventricular fistulae: clinical, angiographic, and pathologic findings

I W Black1, C K Loo, R M Allan

  • 1Department of Cardiovascular Medicine, Prince Henry Hospital, Little Bay, Sydney, Australia.

Insights

This study reports a rare case of multiple coronary artery fistulae connecting to the left ventricle in a woman with angina. The anomaly, confirmed by autopsy, involved abnormal intramyocardial vessels.

Area of Science:

  • Cardiology
  • Pathology
  • Medical Imaging

Background:

  • Coronary artery fistulae are uncommon vascular anomalies.
  • Typical angina symptoms prompted investigation.

Observation:

  • Cardiac catheterization revealed multiple fistulae between all three major coronary arteries and the left ventricle.
  • A 69-year-old woman presented with classic angina symptoms.

Findings:

  • Necropsy confirmed abnormal intramyocardial vessels directly communicating with the left ventricular lumen.
  • This represents the first documented case with integrated clinical, angiographic, and pathological data.

Implications:

  • Highlights the importance of considering rare coronary anomalies in angina diagnosis.
  • Contributes to the understanding of coronary artery anomalies and their presentation.
  • Provides a comprehensive case study for medical education and research.

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