Late Diagnosed Left Coronary to the Pulmonary Artery Large Fistulae: An Interesting and Incidental Cath Lab Finding

Area of Science:

• Cardiology
• Congenital Heart Disease
• Vascular Anomalies

Background:

• Coronary artery anomalies encompass congenital variations in coronary artery origin, course, or structure.
• Coronary artery fistulae are abnormal communications between a coronary artery and a heart chamber or circulatory segment.
• These anomalies are often discovered incidentally during diagnostic procedures or post-mortem examinations.

Purpose of the Study:

• To report a rare case of a large coronary-pulmonary artery fistula.
• To highlight the incidental discovery of this anomaly in a patient presenting with exertional symptoms.
• To contribute to the understanding of coronary artery anomalies and their clinical presentation.

Main Methods:

• Case report of a 67-year-old male patient.
• Diagnostic evaluation included coronary angiography.
• Identification of an incidental coronary-pulmonary artery large fistula.

Main Results:

• Coronary angiography revealed a large fistula between a coronary artery and the pulmonary artery.
• The patient presented with exertional angina and dyspnea.
• The fistula was an incidental finding during the diagnostic workup.

Conclusions:

• Coronary artery fistulae, though rare, can be incidentally discovered.
• This case underscores the importance of recognizing coronary artery anomalies in patients with cardiac symptoms.
• Large coronary-pulmonary artery fistulae may present with exertional angina and dyspnea.