Left anterior descending coronary artery–left ventricular fistula presenting as unstable angina and syncope

Angiographic and Clinical Manifestations of Coronary Fistulas in Chinese People 15-Year Experience

“…1,5,7,8 Other symptoms include fatigue, HF, pulmonary hypertension, rupture or thrombosis of the fistula, atrial arrhythmia, and AP. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] In patients presenting with AP, most are older than 40 years of age and most have coexistent coronary artery stenosis and/or had large or multiple fistulas. Coexistent coronary stenosis or MI were detected in 42 (34%) of the present patients and 34 (25%) underwent PCI or CABG.…”

“…Its symptoms or complications may be either trivial or lethal. [9][10][11][12][13][14][15] Several patients in our study experienced serious morbidity, including MI, HF, and VT/VF with SCD. Previous articles also report serious cases of IE, coronary rupture, and atrial tachyarrhythmia.…”

Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review

“…As per our literature review, we noted only a few case reports of coronary artery fistula between branches of LAD and left ventricle [3,6,12]. We presented two cases of CAFs, both of which were symptomatic but they underwent no intervention as the fistulas are small and multiple, and it was decided that the patients would be followed up closely for any other developing complications.…”

“…These include right-sided chambers, pulmonary artery, superior vena cava, and coronary sinus. Fistulous communication to the left-sided chambers is less frequent (10%) [3]. …”

“…Patients are generally asymptomatic and the fistulas are discovered during cardiac catheterization for congenital heart anomalies or coronary artery disease. Rarely, they can result in heart failure, spontaneous intrapericardial rupture and tamponade or myocardial ischemia due to a coronary ‘steal’ phenomenon [3]. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle.…”