López Bryam, Batallanos Milagros
Department of Cardiology, National Hospital Edgardo Rebagliati Martins, Avenida Edgardo Rebagliati 490, Jesús María, Lima 15072, Perú.
Radiol Case Rep. 2023 Mar 5;18(5):1848-1851. doi: 10.1016/j.radcr.2023.02.020. eCollection 2023 May.
Coronary artery fistulas are abnormal connections between the coronary arteries with a heart chamber or any of the major blood vessels. Fistulous connections between systemic arteries and pulmonary vessels are even less frequent. We present a case of a 71-year-old man with symptoms of dyspnea, exercise intolerance, and ventricular arrhythmia who attended the emergency department. Coronary angiography revealed bilateral coronary fistulas drained into the pulmonary circulation. Computed tomography angiography revealed the presence of fistulas arising from the descending aorta, right internal mammary artery, and subclavian arteries, all these drained into the pulmonary circulation. Due to the rarity of the disease, there are no international guidelines for the management of coronary fistulas and the treatment is controversial. Coronary artery fistula is a rare pathology that should be included in the differential diagnosis of heart failure and ventricular arrhythmia.
冠状动脉瘘是冠状动脉与心腔或任何主要血管之间的异常连接。体循环动脉与肺血管之间的瘘管连接甚至更少见。我们报告一例71岁男性患者，因呼吸困难、运动耐量下降和室性心律失常症状就诊于急诊科。冠状动脉造影显示双侧冠状动脉瘘引流至肺循环。计算机断层扫描血管造影显示存在发自降主动脉、右乳内动脉和锁骨下动脉的瘘管，所有这些瘘管均引流至肺循环。由于该病罕见，目前尚无冠状动脉瘘治疗的国际指南，治疗存在争议。冠状动脉瘘是一种罕见的病理情况，应列入心力衰竭和室性心律失常的鉴别诊断中。
