Multiple coronary cameral fistulae: a rare anomaly and cause of ischaemia

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Interventional Cardiology

Background:

• Coronary artery fistulae are uncommon congenital or acquired abnormalities.
• Pre-operative cardiac evaluation is crucial for patients with cardiovascular risk factors.

Observation:

• An 82-year-old woman with hypertension and diabetes underwent cardiac evaluation.
• Myocardial perfusion imaging showed hypoperfusion in the apicoseptal and inferior segments.

Findings:

• Coronary angiography revealed extensive multiple coronary cameral fistulae.
• These fistulae drained homogeneously and circularly into the left ventricle.

Implications:

• Coronary cameral fistulae can lead to myocardial ischemia despite absence of obstructive coronary artery disease.
• Accurate diagnosis through angiography is essential for appropriate management.
• This case highlights the importance of considering rare coronary anomalies in cardiac evaluations.