Three vessel coronary artery-left ventricular multiple micro-fistulas: a rare angiographic finding
Hossam Abubakar1, Ahmed S Ahmed2, Omeralfaroug Adam1
1Department of Internal Medicine, Wayne state University, Detroit, MI 48201, USA.
Insights
This case study describes a rare heart condition where coronary artery fistulae cause chest pain and reduced heart function. The condition results from a failure in embryonic blood vessel development, leading to myocardial ischemia.
Area of Science:
- Cardiology
- Embryology
- Medical Imaging
Background:
- Coronary artery anomalies are rare congenital heart defects.
- Left ventricular systolic dysfunction can manifest as exertional chest pain.
- Coronary artery fistulae can lead to myocardial ischemia via a coronary steal mechanism.
Abstract:
A 54-year-old woman presents with a long history exertional chest pain and was found to have left ventricular systolic dysfunction on trans-thoracic echocardiogram. Coronary angiography revealed no evidence of atherosclerotic coronary artery disease and showed multiple micro-fistulae draining from all three major coronary arteries to the left ventricle. This rare abnormality is the result of failure of obliteration of intra-trabecular embryonic sinusoids and may cause myocardial ischemia through the coronary steal mechanism.
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