Left ventricular microfistulization: A rare cause of ischemia in a patient with normal coronary arteries
Journal Title: Dicle Tıp Dergisi - Year 2012, Vol 39, Issue 2
Abstract
A 71-year-old woman with chest pain occurring on physical exercise was admitted to cardiology department. Myocardial perfusion scintigraphy revealed inferior and anteroapical segment hypoperfusion. Selective coronary angiography revealed multiple coronary-cameral fistulas originating from the left anterior descending artery and the right coronary artery and emptying into the left ventricle without any significant coronary artery stenosis. Coronary artery fistulas are defined as abnormal communications between a coronary artery and a cardiac chamber or major vessel. Coronary-cameral fistulas terminating in the left ventricle are uncommon. Small fistulas usually do not cause any hemodynamic compromise. However, the larger and multiple fistulas may cause myocardial ischemia ascribed to a coronary steal phenomenon. The best way to manage cameral fistulae is uncertain largely due to the rarity of the condition. In the present case, anti-ischemic medications with metoprolol 50 mg/day provided an uneventful follow-up of six months without any intervention.
Authors and Affiliations
Cihan Şengül, Ayşegül Sünbül, Ender Semiz, İsmet Dindar
Keywords
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