[Inadvertently detected coronary shunts]

The authors analyzed in the form of a retrospective study the clinical picture of coronary arteriovenous fistulae diagnosed by coronarographic examination. A coronary fistula is a rare condition, it was found only in 16 patients, 10 adult men and 6 women, from a total of 5500 coronarographic examinations of adults made in the Institute of Clinical and Experimental Medicine, which corresponds to a 2.9 pro mille incidence. In 6 patients the fistulae were isolated, in 10 they were in a combined form, most frequently with coronary disease. Most frequently the fistulae led into the pulmonary artery and were congenital. The disease was manifested only in adult age, all patients were symptomatic with a variable clinical picture, most frequently with signs of coronary insufficiency. The physical finding, changes in the ECG and X-ray finding, in the ergometric examination and in ventriculography of the left ventricle were conditioned by associated coronary disease. The authors did not detect any specific signs, suggesting the presence of a coronary fistula which would assist the diagnosis before the coronarographic examination.