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Stable angina revealing a post-traumatic coronary cameral fistula: A case report

Nabil Zergoune1, Malak Benabdellah1, Loubna Hara1

  • 1University Hospital Mohamed VI, Cardiology Department, Abdelmalek Essadi University, Tangier, Morocco.

Radiology Case Reports
|June 17, 2024
PubMed

Insights

Coronary-cameral fistulas connect heart chambers and arteries, often asymptomatic until later life. This case highlights a 57-year-old with chest trauma presenting with fistulas causing angina.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Vascular Surgery

Background:

  • Coronary-cameral fistulas are abnormal connections between coronary arteries and heart chambers, presenting as congenital or acquired conditions.
  • While often asymptomatic in youth, symptoms and complications increase with age.
  • Diagnosis relies on coronary angiography, with echocardiography and cardiac MRI as supplementary tools.

Observation:

  • A 57-year-old patient with a history of chest trauma presented with multiple coronary-cameral fistulas.
  • These fistulas connected all three coronary arteries directly to the left ventricle.
  • The condition resulted in myocardial ischemia, manifesting as stable angina.

Findings:

  • The patient's fistulas caused significant hemodynamic shunting.
  • Myocardial ischemia was confirmed as the cause of stable angina.
  • The case illustrates a complex presentation of coronary-cameral fistulas secondary to trauma.

Implications:

  • Early diagnosis and intervention are crucial for managing coronary-cameral fistulas to prevent complications.
  • Treatment strategies range from medical management (beta-blockers, calcium channel blockers) to interventional closure for significant shunts.
  • This case underscores the importance of considering coronary-cameral fistulas in patients with cardiac symptoms, especially post-trauma.

Keywords:
CatheterizationCoronary arteryFistula

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