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[Left coronaro-ventricular microfistula].

T Lefevre1, A Bernard

  • 1Service de cardiologie, hôpital A. Mignot, Le Chesnay.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|March 1, 1988
PubMed
Summary
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Coronary artery microfistulae, often overlooked, are found in over 1% of adult coronary arteriographies. These anomalies frequently cause angina-like symptoms in women without significant coronary artery disease, suggesting a distinct clinical entity.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Context:

  • Coronary artery microfistulae are rare vascular anomalies.
  • Their clinical significance and prevalence have been underestimated.
  • This study investigates their presentation and characteristics in adult patients.

Purpose:

  • To determine the frequency of coronary artery to left ventricle microfistulae.
  • To characterize the clinical presentation, diagnostic findings, and patient demographics.
  • To explore potential etiologies and mechanisms of symptoms.

Summary:

  • A review of 2,520 coronary arteriographies identified 34 cases of coronary artery microfistulae.
  • Most patients (28) without infarction or valve disease presented with angina-like symptoms.

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  • Ischemic signs were common on ECG (19/28), and positive in exercise tests/scintigraphy (2/3).
  • Isolated microfistulae predominantly affected women (19/21) in their fifties, often without atheromatous disease.

    • Impact:

    • Microfistulae are found in over 1% of adult coronary arteriographies, and 8% of those with normal coronary arteries.
    • These findings suggest microfistulae represent a distinct cause of angina, particularly in women.
    • Further research is needed to clarify their embryonic origin, symptom mechanisms, and relationship to "healthy coronary artery angina".