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Dual Coronary-Pulmonary Fistula Firstly Found at Routine Doppler Echocardiogram

Grazia Casavecchia1, Stefano Zicchino1, Matteo Gravina1

  • 1Cardiology Department, University of Foggia, Foggia, Italy.

Journal of Cardiovascular Echography
|April 23, 2019
PubMed

Insights

Congenital coronary-pulmonary fistulas (CPFs) are rare abnormal connections between coronary arteries and the pulmonary artery. Echocardiography can help detect these fistulas, aiding in early diagnosis and management.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Thoracic Surgery

Background:

  • Congenital coronary-pulmonary fistulas (CPFs) represent anomalous direct communications between coronary arteries and thoracic structures, bypassing the normal capillary network.
  • These fistulas can lead to significant cardiovascular complications if left undiagnosed.

Observation:

  • A 73-year-old male with hypertension, asymptomatic for angina and dyspnea, underwent routine clinical evaluation.
  • Echocardiography revealed unexpected diastolic flow from the pulmonary trunk, confirmed by pulsed-wave Doppler with a characteristic coronary flow pattern.

Findings:

  • Coronary angiography identified dual CPFs originating from the left anterior descending and right coronary arteries.
  • The findings highlight the diagnostic utility of echocardiography in identifying CPFs.

Implications:

  • Routine Doppler echocardiography can raise suspicion for CPFs in patients with unexplained symptoms.
  • Echocardiography serves as a simple, accessible tool for initial diagnosis and ongoing monitoring of CPFs.

Keywords:
Coronary anomalycoronary fistuladoppler echocardiogram

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