Giant Right Coronary Artery with Coronary Artery Fistula Complicated by Infective Endocarditis: Multimodality Imaging Approach

Lee, Dongjae; Jung, Mi‐Hyang; Youn, Ho‐Joong; Choi, Young; Byeon, Jae Ho; Jung, Hae Ok

doi:10.4070/kcj.2016.0268

Cited by 2 publications

(4 citation statements)

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“… 1 , 3 , 9 Several studies show that the right coronary artery (RCA) is typically the most involved, followed by the LAD, LCX, and the left main, which is rarely affected. 1 , 5 , 6 There are several potential complications of CAAs. They are predisposed to thrombus formation due to prolonged abnormal flow.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 10 In a few described reports, vasospasm and fistulation have been reported. 5 , 11 These aneurysms may also rupture, leading to sudden cardiac death in some cases. 3 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

“…For asymptomatic minor aneurysms, medical management may be appropriate; however, for most aneurysms, surgical intervention should be considered. 1 , 5 , 15 , 16 Anticoagulation is based on the observations of thrombus formation, with limited data on its efficacy. 1 , 14 , 16 In our case, our patient was deemed a poor surgical candidate and was treated conservatively with management for his heart failure, VT, and known atrial appendage clot.…”

Section: Discussionmentioning

confidence: 99%

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A case report of a giant coronary artery aneurysm masquerading as a ventricular mass

Prathivadhi-Bhayankaram,

Ashwath

2024

European Heart Journal - Case Reports

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Background A coronary artery aneurysm (CAA) is a dilation exceeding 1.5 times the diameter of the patient's largest coronary vessel. They are rare, varying in prevalence between 1.4–4.9%. Additionally, they carry a high risk of potential complications, including thrombosis and myocardial infarction, with a risk of rupture. We present an interesting case of a patient with initial imaging suggesting a mass in the right ventricle. Case Summary This patient initially presented with acute hypoxic respiratory failure related to pulmonary edema. His course was complicated by symptomatic ventricular tachycardia and an inferoposterior myocardial infarction. Further investigation revealed a left anterior descending artery and circumflex artery thrombosed aneurysm projecting into the right ventricle. Multimodal imaging was used to arrive at his diagnosis. He continues to do well on medical therapy for coronary artery disease and heart failure. Discussion Clinicians should be vigilant for this rare pathology, which may be easily missed yet poses a high mortality risk. Our case demonstrates the benefit of multimodal imaging, as this patient’s aneurysm was initially mistaken for a ventricular mass.

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Section: Discussionmentioning

confidence: 99%

“… 1 , 10 In a few described reports, vasospasm and fistulation have been reported. 5 , 11 These aneurysms may also rupture, leading to sudden cardiac death in some cases. 3 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case report of a giant coronary artery aneurysm masquerading as a ventricular mass

Prathivadhi-Bhayankaram,

Ashwath

2024

European Heart Journal - Case Reports

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“…Current literature reflects several cases of congenital fistulas complicated by endocarditis but few endocarditis-associated acquired fistulas. 3–5 Our patient was undergoing surgical or percutaneous evaluation for definitive treatment but left against medical advice (AMA). Treatment is recommended for patients at risk for haemodynamic compromise.…”

Section: Introductionmentioning

confidence: 99%

A case report of superior vena cava/right coronary artery fistula secondary to chronic endocarditis

Kiel,

Prathivadhi-Bhayankaram,

Singhal

et al. 2024

European Heart Journal - Case Reports

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Background Coronary arteriovenous fistulas present an abnormal connection between the coronary arteries and an adjacent systemic or pulmonary vessel. They are rare, representing 0.002% of the general population.1 The majority are congenital but may additionally occur related to trauma or interventional cardiac procedures. Case summary We present the case of a 48-year-old male with a history of untreated bacterial endocarditis developing a right coronary/superior vena cava fistula. We detail the imaging findings of this rare phenomenon to arrive at this diagnosis. We describe his clinical course and the interventions considered, including surgical extraction. Unfortunately, this patient left against medical advice before completing recommended treatment. Discussion We present the first documentation of a right coronary/superior vena cava fistula secondary to chronic untreated bacterial endocarditis. Clinicians should be aware of this rare complication.

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Giant Right Coronary Artery with Coronary Artery Fistula Complicated by Infective Endocarditis: Multimodality Imaging Approach

Cited by 2 publications

References 0 publications

A case report of a giant coronary artery aneurysm masquerading as a ventricular mass

A case report of a giant coronary artery aneurysm masquerading as a ventricular mass

A case report of superior vena cava/right coronary artery fistula secondary to chronic endocarditis

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