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Three main coronary arteries to pulmonary artery fistula
Insights
A rare case of coronary artery fistula involving three major coronary arteries was found in an asymptomatic young woman. This unusual anomalous coronary-pulmonary artery communication presented with a continuous murmur and mitral valve prolapse.
Area of Science:
- Cardiology
- Medical Case Reports
- Vascular Anomalies
Background:
- Coronary artery fistulas are rare congenital or acquired abnormalities where coronary arteries connect directly to heart chambers or great vessels.
- While often asymptomatic, they can lead to significant cardiovascular complications.
Observation:
- A 19-year-old woman presented with an incidental finding of a continuous murmur.
- Echocardiograms revealed mitral valve prolapse.
- Selective coronary arteriograms were performed for further investigation.
Findings:
- The study details a unique case of anomalous coronary-pulmonary artery communication.
- An arteriovenous fistula was identified between branches of the right, left anterior descending, and left circumflex coronary arteries and the main pulmonary trunk.
- This represents the first reported instance where three main coronary vessels participate in such a fistula.
Implications:
- This case expands the understanding of coronary artery fistula variations and their potential anatomical complexity.
- Highlights the importance of thorough cardiovascular evaluation in patients with murmurs, even if asymptomatic.
- Contributes to the literature on rare congenital heart anomalies and their clinical presentation.
Abstract:
A case of a 19-year-old woman with coronary artery fistula was reported. She was asymptomatic throughout her life. Physical examination revealed a continuous murmur along the left sternal border. Echocardiograms and left ventriculograms showed mitral valve prolapse. Selective coronary arteriograms disclosed arteriovenous fistula between branches of the right, the left anterior descending and the left circumflex coronary artery and the main pulmonary trunk. We believe that this is the first case report of an unusual form of anomalous coronary-pulmonary artery communication: three main coronary vessels participate in the fistula.