Coronary Fistula-Induced Ventricular Tachycardia From Thrombotic Cyst Compression: A Case Report
Xuelin Lu1, Xiaoqin Duan2, Zuoan Qin3
1Department of Pathology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, China.
Background:
Coronary artery fistula (CAF) complicated by thrombotic cyst formation is a rare cause of ventricular tachycardia (VT), involving ischemia and mechanical compression.
Case Presentation:
A 55-year-old woman presented with palpitations, chest pain, monomorphic VT (negative V1-V6), and elevated troponin I. Imaging revealed a large right ventricular cyst. Surgical resection confirmed a thrombotic cyst communicating with a CAF. Postoperative VT recurred, leading to cardiogenic shock and death.
Conclusions:
CAF-related thrombotic cysts can cause irreversible myocardial fibrosis, creating a persistent VT substrate unresponsive to anatomical intervention alone. ECG markers (fragmented QRS, ST depression) reflect irreversible damage.
Related Concept Videos
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Coronary Artery Disease III: Clinical Manifestations
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias II: Classification of Tachyarrhythmias
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...


