Casavecchia Grazia, Zicchino Stefano, Gravina Matteo, Martone Alessandro, Cuculo Andrea, Macarini Luca, Di Biase Matteo, Brunetti Natale Daniele
Cardiology Department, University of Foggia, Foggia, Italy.
Cardiology Department, Ospedali Riuniti, Bari, Italy.
J Cardiovasc Echogr. 2019 Jan-Mar;29(1):23-25. doi: 10.4103/jcecho.jcecho_47_18.
Congenital coronary-pulmonary fistulas (CPFs) are defined as an abnormal direct communication between one or more coronary arteries, with a cardiac or thoracic structure bypassing the capillary network. We report the case of a 73-year-old male, with a history of hypertension, asymptomatic for angina and dyspnea, who was referred for routine clinical control. Echocardiogram unexpectedly showed the presence of diastolic flow from the pulmonary trunk in parasternal short-axis view. Pulsed-wave Doppler confirmed the presence of diastolic flow and displayed the typical coronary flow pattern. Coronary angiography hence showed the presence of dual CPFs originating from the second segment of the left anterior descending coronary and the right coronary arteries. Careful routine Doppler echocardiograph examination may raise the suspicion of CPF in case of otherwise unexplained symptoms and may represent a simple, easy, repeatable tool for the first suspected diagnosis and follow-up of CPFs.
先天性冠状动脉-肺瘘（CPF）定义为一条或多条冠状动脉与心脏或胸部结构之间存在异常直接连通，绕过毛细血管网。我们报告一例73岁男性病例，有高血压病史，无心绞痛和呼吸困难症状，因常规临床检查前来就诊。超声心动图意外显示在胸骨旁短轴视图中肺动脉干有舒张期血流。脉冲波多普勒证实存在舒张期血流并显示出典型的冠状动脉血流模式。冠状动脉造影因此显示存在起源于左前降支冠状动脉第二段和右冠状动脉的双发性CPF。在出现无法解释的症状时，仔细的常规多普勒超声心动图检查可能会引发对CPF的怀疑，并且可能是CPF初步疑似诊断和随访的一种简单、易行、可重复的工具。
