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Severe form of persistent thebesian veins presenting as ischemic heart disease

Younghee Jung1, Hyun-Jin Kim, Chang-Hwan Yoon

  • 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Korean Circulation Journal
|November 22, 2012
PubMed

Insights

Persistent Thebesian veins, a rare coronary artery anomaly, can cause myocardial ischemia. This case highlights the importance of recognizing these fistulae for effective patient management and treatment.

Area of Science:

  • Cardiology
  • Congenital Heart Disease

Background:

  • Coronary artery fistula is a rare congenital anomaly.
  • While often asymptomatic, it can lead to heart failure, myocardial ischemia, or arrhythmias.

Purpose of the Study:

  • To report a case of myocardial ischemia caused by persistent Thebesian veins.
  • To describe the diagnostic findings and management of this rare condition.

Main Methods:

  • Case report presentation.
  • Diagnostic coronary angiography to visualize the fistula and its drainage.

Main Results:

  • The patient presented with myocardial ischemia.
  • Coronary angiography revealed multiple microfistulae draining into the left ventricle via persistent Thebesian veins.
  • The patient improved with medical management.

Conclusions:

  • Persistent Thebesian veins can be a cause of myocardial ischemia.
  • Medical management with beta-blockers and ACE inhibitors can be effective.
  • Coronary angiography is crucial for diagnosis.

Keywords:
Arteriovenous fistulaCoronary angiographyCoronary vessel anomaliesMyocardial ischemia

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