Maknojia Arish, Pride Yuri, Ghatak Abhijit, Lee Jin
Internal Medicine Department, Northside Hospital Gwinnett, Lawrenceville, USA.
Cardiology Department, Cardiovascular Group, Lawrenceville, USA.
Cureus. 2021 Feb 12;13(2):e13316. doi: 10.7759/cureus.13316.
Coronary-cameral fistulae (CCF) are rare, frequently incidental findings uncommonly noted during routine coronary angiography. They are nearly always congenital and are sometimes associated with other cardiac malformations. They can also be acquired due to trauma or chronic inflammation. These fistulae most commonly originate from the right coronary artery. The site of termination is usually the right ventricle (RV) and rarely the left ventricle (LV). Though nearly always asymptomatic and clinically insignificant, depending on their size and pressure gradient between communicating sites and terminating area, CCF can lead to pulmonary hypertension, LV dysfunction, and myocardial infarction. We describe the case of a 55-year-old woman who presented with worsening dyspnea and lower extremity edema. Transthoracic echocardiography demonstrated an ejection fraction of 55% with an RV systolic pressure of 67 mmHg. Right heart catheterization was performed to formally diagnose pulmonary hypertension and left heart catheterization was performed concurrently. This demonstrated a fistula between the first obtuse marginal branch of the left circumflex artery to the LV cavity. In this report, the authors provide a brief review of the presentation, diagnosis, complications, and management of CCF.
冠状动脉-心腔瘘（CCF）较为罕见，常在常规冠状动脉造影时偶然发现。它们几乎都是先天性的，有时与其他心脏畸形相关。也可因外伤或慢性炎症而后天获得。这些瘘管最常起源于右冠状动脉。终止部位通常是右心室（RV），很少是左心室（LV）。尽管CCF几乎总是无症状且临床意义不大，但根据其大小以及交通部位与终止部位之间的压力梯度，CCF可导致肺动脉高压、左心室功能障碍和心肌梗死。我们描述了一名55岁女性的病例，她出现了进行性加重的呼吸困难和下肢水肿。经胸超声心动图显示射血分数为55%，右心室收缩压为67 mmHg。进行了右心导管检查以正式诊断肺动脉高压，并同时进行了左心导管检查。结果显示左旋支动脉的第一钝缘支与左心室腔之间存在瘘管。在本报告中，作者简要回顾了CCF的表现、诊断、并发症及治疗。
