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[Color Doppler echocardiographic diagnosis in generalized arteriosystemic coronary fistulae]
C Nanke1, M Stellwaag, A Gesekus
1Fachbereich Kardiologie, Deutsche Klinik für Diagnostik, Wiesbaden.
Insights
This study highlights color-coded Doppler echocardiography as a novel diagnostic tool for generalized arteriosystemic coronary artery fistulas. It successfully identified multiple connections between the epicardium and left ventricle, confirming the rare condition.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Vascular Medicine
Background:
- Coronary artery fistulas are rare, abnormal connections between a coronary artery and a heart chamber or vessel.
- Generalized arteriosystemic coronary artery fistulas involve multiple fistulous connections throughout the coronary system.
- Diagnosis often relies on invasive procedures like coronary angiography.
Observation:
- A 60-year-old woman presented with retrosternal pain.
- Transthoracic color-coded Doppler echocardiography revealed multiple epicardial connections to the left ventricular chamber in the apical region.
Findings:
- The echocardiographic findings were consistent with generalized arteriosystemic coronary artery fistulas.
- Coronary angiography confirmed multiple small coronary artery fistulas leading to intense, homogeneous opacification of the ventricle.
- This case marks the first documented use of color-coded Doppler echocardiography for diagnosing this condition.
Implications:
- Color-coded Doppler echocardiography offers a non-invasive and effective method for diagnosing generalized arteriosystemic coronary artery fistulas.
- This imaging modality may reduce the need for invasive angiography in diagnosing coronary artery fistulas.
- Early and accurate diagnosis can lead to timely management and improved patient outcomes.
Abstract:
A 60-year-old woman was referred because of retrosternal pain. Transthoracic color-coded Doppler echocardiography showed, in the apical region of the left ventricle, multiple connections between the epicardium and the left ventricular chamber. The finding was concordant with a generalized arteriosystemic coronary artery fistula. Coronarography afterwards with injection of dye into left and right coronary arteries resulted in an intense homogenous opacification of the ventricle through multiple small coronary artery fistulas. This case report represents the first description of color-coded Doppler echocardiography in the diagnosis of generalized arteriosystemic coronary artery fistulas.