Coronary Artery Fistula Causing Acute Myocardial Infarction and Right Ventricle Thrombus

Santos, Eduardo L.; Gouveia, Milena Motta; Silva, Ricardo F; Ávila, Renata Andrade; Aquino, Maria Améllia R; Dompieri, Luca Terracini; Lópes, Renato D.

doi:10.7759/cureus.2314

Cited by 2 publications

(2 citation statements)

References 3 publications

(8 reference statements)

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“…Even though most patients are asymptomatic, it may also cause serious consequences i.e. myocardial ischemia, thromboembolism, cardiac failure, arrhythmias, rupture, and endocarditis 16,17 . Spontaneous rupture of the aneurysmal fistula causing hemopericardium has also been reported 1 .…”

Section: Discussionmentioning

confidence: 99%

Left Anterior Descendent Coronary Artery Fistula to Main Pulmonary Artery with Triple Vessel Disease:A Report of Two Cases

Darwin,

Sembiring,

Sediono Pribadi

2021

Indian Journal of Forensic Medicine & Toxicology

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Coronary artery fistula is a rare anomaly of coronary artery. It represents connection between one or more of coronary arteries and cardiac chamber or great vessel. It can also cause significant hemodynamic changes. To report cases of left anterior descending coronary artery (LAD) fistula to main pulmonary artery (MPA) with concomitant triple vessel disease.Case 1 was 59-year old male presented with intermittent chest discomfort for a year. Echocardiogram showed severe MR with cleft at A1 and A2 and coronary angiogram result showed LAD fistulation to MPA. Case 2 was 57-year old male presented with chest discomfort and at the left shoulder. Echocardiogram showed trivial MR and coronary angiogram showed triple vessel disease along with tortuous fistulation of LAD to MPA. Both patients underwent teflonpledget-reinforced direct suturing of fistula origin and 3-grafts coronary artery bypass graft. Patient no 1 also underwent mitral annuloplasty and valvuloplasty.Post-operative period was uneventful and both patients were discharged after 17 days and 5 days respectively. Short term follow-up showed improvement of symptoms and no residual fistulation.In short term follow-up teflonpledget-reinforced direct suturing of coronary fistula origin result satisfactory. Larger study and further follow up is necessary.

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Section: Discussionmentioning

confidence: 99%

Left Anterior Descendent Coronary Artery Fistula to Main Pulmonary Artery with Triple Vessel Disease:A Report of Two Cases

Darwin,

Sembiring,

Sediono Pribadi

2021

Indian Journal of Forensic Medicine & Toxicology

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“…Differing pathophysiologic mechanisms are attributed to angina in the setting of CAFs, including ‘coronary steal phenomenom’ reflecting the abnormal pressure gradient from a high pressure coronary artery to a low pressure venous capacitance chamber, and the clinical significance of specific CAFs that can cause reversible ischemia and angina [1,3]. Myocardial infarction (MI), either ST-elevation MI or non-ST elevation MI (NSTEMI), has been previously reported, but is a rare clinical manifestation of CAF in the absence of CAF thrombosis [1,11,12]. Given the typical asymptomatic nature and patterns of incidental discovery of CAFs on radiology or angiography, guidelines on diagnostic imaging and management are discrepant and evolving [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Right Coronary Artery-Superior Vena Cava Fistula Manifesting as NSTEMI: Case Report, Review of Imaging, and Summary of Guidelines

Wengrofsky

Kariyanna

Kupferstein

et al. 2019

AJMCR

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Coronary artery fistulas (CAFs) represent a spectrum of abnormal connections between a coronary artery and another coronary artery, vein, or major blood vessel, known as coronary-vascular fistulas, or between a coronary artery and a cardiac chamber, known as coronary-cameral fistulas. While CAFs generally remain asymptomatic into the fifth decade of adult life, they can present with a diverse symptomatic profile, typically with angina from abnormal myocardial perfusion, or in the setting of larger fistulas, as right-or left-heart failure from pulmonary or left ventricular circulatory overload. CAFs rarely manifest as myocardial infarction in the absence of thrombosis within the fistula. When clinically suspected based on a continuous murmur on physical exam or an accidental finding on radiology, computed tomography angiography (CTA) and coronary angiography are the preferred diagnostic imaging modalities. Fistula anatomic and patient specific characteristics guide clinical decisions on transcatheter or surgical management strategies. We present the case of a right coronary artery-superior vena cava fistula manifesting as a non-ST elevation myocardial infarction. We also present a review of the imaging techniques available for evaluation of CAFs, and a summary of the major national and international cardiology society guidelines on the diagnosis and management of CAFs.

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Coronary Artery Fistula Causing Acute Myocardial Infarction and Right Ventricle Thrombus

Cited by 2 publications

References 3 publications

Left Anterior Descendent Coronary Artery Fistula to Main Pulmonary Artery with Triple Vessel Disease:A Report of Two Cases

Left Anterior Descendent Coronary Artery Fistula to Main Pulmonary Artery with Triple Vessel Disease:A Report of Two Cases

Right Coronary Artery-Superior Vena Cava Fistula Manifesting as NSTEMI: Case Report, Review of Imaging, and Summary of Guidelines

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