Multiple Coronary Artery Fistulas and 3-Vessel Disease in an Elderly Patient With Unstable Angina
Edwin A Rodríguez1, Tatiana M Martinez Soley1, Carolina Escobar Restrepo1
1Department of Cardiology, José de San Martín Hospital, University of Buenos Aires, Buenos Aires, Argentina.
Insights
Multiple coronary artery fistulas (CAFs) co-occurring with coronary artery disease (CAD) in an elderly patient presented atypically. This rare case highlights diagnostic and management challenges for this complex cardiovascular condition.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Coronary artery fistula (CAF) is a rare vascular anomaly.
- CAFs typically do not involve atherosclerotic coronary artery disease (CAD).
Background:
Coronary artery fistula (CAF) is an atypical vascular communication that drains into a cardiac chamber or vessel and is usually unrelated to atherosclerotic coronary artery disease (CAD).
Case Summary:
An elderly patient with high-risk unstable angina underwent coronary angiography, which revealed 3-vessel CAD and multiple CAFs. Medical treatment was elected.
Discussion:
Multiple CAFs, especially a large right CAF draining into the left ventricle in the context of significant 3-vessel CAD in an elderly patient, represent a rare finding with an unusual presentation of unstable angina. This case highlights the diagnostic challenges and management considerations in such complex scenarios, enriching the limited available literature.
Take-Home Message:
The co-occurrence of multiple CAFs with CAD creates a unique management challenge, requiring a tailored approach that extends beyond the current limited literature.
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