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A case of right coronary artery to left ventricle fistula: two-dimensional echocardiographic study
Insights
A rare coronary arteriovenous fistula was diagnosed in a 12-year-old boy. Two-dimensional echocardiography effectively visualized the dilated right coronary artery and its connection to the left ventricle.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Diagnostic Imaging
Background:
- Coronary arteriovenous fistulas (CAVF) are uncommon congenital heart defects.
- Diagnosis often relies on invasive procedures like cardiac catheterization and angiography.
- Characteristic murmurs can suggest the presence of a fistula.
Observation:
- A 12-year-old boy presented with a decrescendo diastolic murmur.
- Cardiac catheterization and angiography confirmed a right coronary artery to left ventricle fistula.
- The right coronary artery was markedly dilated.
Findings:
- Two-dimensional echocardiography revealed a dilated right coronary artery.
- The fistula originated from the right coronary artery and emptied into the left ventricle.
- Echocardiography accurately depicted the fistula's course and termination.
Implications:
- This case highlights the diagnostic utility of two-dimensional echocardiography for visualizing coronary artery anomalies.
- Non-invasive imaging may play a greater role in diagnosing CAVF.
- Early and accurate diagnosis is crucial for appropriate management of pediatric cardiac conditions.
Abstract:
A 12-year-old boy with a decrescendo diastolic murmur maximal at the lower right sternal border was suspected of having a coronary arteriovenous fistula. Cardiac catheterization and angiography revealed a right coronary artery to left ventricle fistula with marked dilatation of the right coronary artery. This is the thirteenth case of this anomaly reported in the literature. Characteristic two-dimensional echocardiographic features of this case are presented. A markedly dilated right coronary artery was revealed by two-dimensional echocardiography to take a normal right coronary artery course and empty into the posteromedial portion of the left ventricle. This case indicates the possibility of visualizing a dilated peripheral portion of the right coronary artery using two-dimensional echocardiography.