Multiple coronary artery-left ventricular fistulas: a pattern of anomalous coronary microvascularization
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R L Gonda1, O H Gutierrez, A J Moss
1Department of Radiology, University of Rochester Medical Center Strong Memorial Hospital, Rochester, NY 14642.
Insights
Multiple coronary artery-left ventricular fistulas are rare heart anomalies. Recognizing these fistulas is crucial for diagnosing angina in patients without typical coronary artery disease.
Area of Science:
- Cardiology
- Congenital Heart Disease
Background:
- Coronary artery-left heart chamber fistulas are rare, particularly those involving the left ventricle.
- Previous literature reports 33 cases of coronary artery-left ventricular fistulas, with 7 exhibiting multiple communications.
Observation:
- This report details findings in 6 additional patients diagnosed with multiple coronary artery-left ventricular fistulas.
- In three of these patients, fistulas originated from all three major coronary arteries.
Findings:
- The study expands the known cases of coronary artery-left ventricular fistulas.
- Multiple communications from coronary arteries to the left ventricle were observed in the presented cases.
Implications:
- Coronary artery-left ventricular fistulas can be an overlooked cause of angina.
- Early recognition of this anomaly is vital for accurate diagnosis and management in patients presenting with angina and no significant atherosclerotic coronary artery disease.
Abstract:
Fistulas between the coronary artery and the left heart chambers are exceptionally rare, especially those emptying into the left ventricle. We know of 33 cases of coronary artery-left ventricular fistulas reported in the literature, 7 of which had multiple communications. The findings in 6 additional patients with multiple coronary artery-left ventricular fistulas are reported. Three of the 6 patients from all three major coronary arteries. It is important to recognize this anomaly as it may be the source of angina in patients without angiographic evidence of major atherosclerotic coronary artery disease.