Dadkhah-Tirani Heidar, Salari Arsalan, Shafighnia Shora, Hosseini Seyed Fazel, Naghdipoor Misa
Department of Cardiology, Dr. Heshmet Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Am J Case Rep. 2013 Nov 18;14:486-8. doi: 10.12659/AJCR.889416. eCollection 2013.
Male, 69 FINAL DIAGNOSIS: Coronary artery to pulmonary artery fistula Symptoms: Chest pain Medication: - Clinical Procedure: Echocardiography • angiography • surgical intervention Specialty: Cardiology • Cardiac Surgery.
Rare disease.
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.
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).
Surgical treatment was chosen because of the total occlusion of the right coronary artery and to relieve of pain to improve quality of life.
男性，69岁 最终诊断：冠状动脉至肺动脉瘘 症状：胸痛 用药：- 临床操作：超声心动图•血管造影•手术干预 专科：心脏病学•心脏外科。
罕见疾病。
冠状动脉瘘是冠状动脉与心脏腔室或大血管之间的异常连通，从而绕过心肌毛细血管网。它们通常在冠状动脉造影时偶然发现。临床表现因瘘的类型、分流严重程度、分流部位以及是否存在其他心脏疾病而异。
我们报告一名69岁男性，既往无任何病史，因胸痛入院。心电图（ECG）显示窦性心律，胸前导联V2至V6 ST段压低。冠状动脉造影显示左前降支冠状动脉（LAD）至主肺动脉的冠状动脉瘘、右冠状动脉阻塞以及LAD和左旋支动脉（LCX）的明显狭窄。
由于右冠状动脉完全闭塞且为缓解疼痛以改善生活质量，选择了手术治疗。
