Coexistence of atherosclerosis and fistula as a cause of angina pectoris: a case report

Papadopoulos, Dimitris P.; Bourantas, Christos V.; Ekonomou, Chrisostomos; Votteas, V.

doi:10.1186/1757-1626-3-70

Cited by 8 publications

(11 citation statements)

References 9 publications

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“…Few LAD fistulas ended in the LV, RV, RA and LA [1,38,93,94] . The clinical presentations of LAD fistulas were usually chest pain [76] , angina pectoris [90,95] , dyspnea [41,82,92,[96][97][98] , fatigue [99] , palpitations [1,74] , syncope [100] , CHF [77,[101][102][103] or IE [1,38] . Cx fistulas terminated into the PA in (23%) [47,104] , but the majority ended in the CS in 40% [43,[105][106][107][108][109] and the RA in 15% [73,78,110] of cases.…”

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

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AIM:To describe the characteristics of coronary artery fistulas (CAFs) in adults, including donor vessels and whether termination was cameral or vascular. METHODS:A PubMed search was performed for articles between 2000 and 2010 to describe the current characteristics of congenital CAFs in adults. A group of 304 adults was collected. Clinical data, presentations, diagnostic modalities, angiographic fistula findings and treatment strategies were gathered and analyzed. With regard to CAF origin, the subjects were tabulated into unilateral, bilateral or multilateral fistulas and compared. The group was stratified into two major subsets according to the mode of termination; coronary-cameral fistulas (CCFs) and coronary-vascular fistulas (CVFs). A comparison was made between the two subsets. Fistula-related major complications [aneurysm formation, infective endocarditis (IE), myocardial infarction (MI), rupture, pericardial effusion (PE) and tamponade] were described. Coronary artery-ventricular multiple micro-fistulas and acquired CAFs were excluded as well as anomalous origin of the coronary arteries from the pulmonary artery (PA). RESULTS:A total of 304 adult subjects (47% male) with congenital CAFs were included. The mean age was 51.4 years (range, 18-86 years), with 20% older than 65 years of age. Dyspnea (31%), chest pain (23%) and angina pectoris (21%) were the prevalent clinical presentations. Continuous cardiac murmur was heard in 82% of the subjects. Of the applied diagnostic modalities, chest X-ray showed an abnormal shadow in 4% of the subjects. The cornerstone in establishing the diagnosis was echocardiography (68%), and conventional contrast coronary angiography (97%). However, multislice detector computed tomography was performed in 16%. The unilateral fistula originated from the left in 69% and from the right coronary artery in 31% of the subjects. Most patients (80%) had unilateral fistulas, 18% presented with bilateral fistulas and 2% with multilateral fistulas. Termination into the PA was reported in unilateral (44%), bilateral (73%) and multilateral (75%) fistulas. Fistulas with multiple origins (bilateral and multilateral) terminated more frequently into the PA (29%) than into other sites (10.6%) (P = 0.000). Aneurysmal formation was found in 14% of all subjects. Spontaneous rupture, PE and tamponade were reported in 2% of all subjects. In CCFs, the mean age was 46.2 years whereas in CVFs mean age was 55.6 years (P = 0.003). IE (4%) was exclusively associated with CCFs, while MI (2%) was only found in subjects with CVFs. Surgical ligation was frequently chosen for unilateral (57%), bilateral (51%) and multilateral fistulas (66%), but percutaneous therapeutic embolization (PTE) was increasingly reported (23%, 17% and 17%, respectively). CONCLUSION:Congenital CAFs are currently detected in elderly patients. Bilateral fistulas are more frequently reported and PTE is more frequently applied as a therapeutic strategy in adults.

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Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

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“…The most common site of drainage is the right ventricle (41%), followed by the right atrium (26%) and the pulmonary artery (17%) [9,10]. A fistula between the left anterior descending artery and the main pulmonary artery, referred to as a coronary-pulmonary artery fistula (CPAF), as described in this case, is a very unusual finding [11,12].…”

Section: Discussionmentioning

confidence: 99%

Large Aneurysmal Rupture of Coronary-Pulmonary Artery Fistula After Buffalo Goring

et al. 2019

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Congenital defects/diseases Background: Coronary-to-pulmonary artery fistulas are congenital coronary anomalies that are often incidentally found and no hemodynamic significance. They are abnormal vessels originating from the coronary artery and terminating into the pulmonary artery, with a tortuous pathway. However, coronary-pulmonary artery fistula associated with coronary artery aneurysm is a rare condition that can cause cardiac death. Case Report: A 55-year-old Thai woman diagnosed with traumatic aortic injury after being gored by a buffalo was incidentally found by computed tomography (CT) to have a coronary arteriovenous fistula with large aneurysm. One week after urgent thoracic endovascular aortic repair (TEVAR), she had a cardiac tamponade. Median sternotomy was performed for diagnosis and treatment. The final diagnosis was rupture of a large aneurysm of the coronary-pulmonary artery fistula (CPAF). No complications were found and the patient was discharged 2 weeks after surgery. Conclusions: CPAF associated with rupture of a giant coronary aneurysm is a rare and life-threatening condition. Prompt diagnosis and emergency surgery are essential to treatment of these patients.

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“…Coronary artery fistulas (CAF) are uncommon vascular communications between a coronary artery and one of the cardiac chambers or a great vessel around heart, so lead to bypass the myocardial capillary network [ 1 – 3 ]. Coronary artery fistulae represent the most frequent congenital anomalies of the coronary arteries, but remain a relatively uncommon clinical problem [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Coronary artery fistulae represent the most frequent congenital anomalies of the coronary arteries, but remain a relatively uncommon clinical problem [ 4 ]. These fistulas are usually discovered incidentally upon coronary angiography [ 2 , 3 ]. Various symptoms and signs related to the fistula depending on the type of fistula, shunt volume, site of shunt, and presence of other cardiac conditions [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The majority of these fistulas are congenital but can nevertheless arise after a cardiac surgery [ 4 ]. Their incidence in the overall population is reported about 0.002% [ 1 – 3 ] and constitute 0.13% of congenital cardiac lesion [ 1 , 3 ] however, they are found in 0.05% to 0.25% of patients who undergo coronary angiography [ 5 ]. The most common site of drainage is the right ventricle (41%) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Coronary artery to pulmonary artery fistula

et al. 2013

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Patient: Male, 69Final Diagnosis: Coronary artery to pulmonary artery fistulaSymptoms: Chest painMedication: —Clinical Procedure: Echocardiography • angiography • surgical interventionSpecialty: Cardiology • Cardiac SurgeryObjective:Rare diseaseBackground:A coronary artery fistula is an abnormal communication between a coronary artery and one of the cardiac chambers or a great vessel, so bypassing the myocardial capillary network. They are usually discovered incidentally upon coronary angiography. Clinical manifestations are variable depending on the type of fistula, the severity of shunt, site of shunt, and presence of other cardiac condition.Case Report:We report a 69-year-old man without any previous medical history, who was admitted to our hospital with chest pain. The electrocardiogram (ECG) showed a sinus rhythm with ST depression in V2 to V6 precordial leads. Coronary angiography revealed a coronary artery fistula from left anterior descending coronary artery (LAD) to the main pulmonary artery, right coronary artery blockage and significant stenoses on the LAD and left circumflex artery (LCX).Conclusions:Surgical treatment was chosen because of the total occlusion of the right coronary artery and to relieve of pain to improve quality of life.

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Coexistence of atherosclerosis and fistula as a cause of angina pectoris: a case report

Cited by 8 publications

References 9 publications

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Large Aneurysmal Rupture of Coronary-Pulmonary Artery Fistula After Buffalo Goring

Coronary artery to pulmonary artery fistula

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