Chia B L, Ee B, Tan A, Choo M, Tan L
Chest. 1984 Dec;86(6):901-4. doi: 10.1378/chest.86.6.901.
We describe two patients who presented with precordial continuous murmurs which were diagnosed clinically as due to patent ductus arteriosus; however, two-dimensional echocardiographic and pulsed Doppler echocardiographic studies showed dilatation of the left main coronary artery with turbulent flow during systole in the lumen in both patients. Subsequent selective coronary angiographic studies showed bilateral coronary artery-pulmonary artery fistula in one patient and left coronary artery-pulmonary artery fistula in the other. This study illustrates that in a patient presenting with a continuous murmur which is suggestive of patent ductus arteriosus, such two-dimensional and pulsed Doppler echocardiographic findings as were seen in our patients should immediately alert the physician that he may be dealing with a case of coronary arterial fistula.
我们描述了两名患者，他们均表现为心前区连续性杂音，临床诊断为动脉导管未闭；然而，二维超声心动图和脉冲多普勒超声心动图研究显示，两名患者的左冠状动脉主干均有扩张，且在收缩期管腔内有湍流。随后的选择性冠状动脉造影研究显示，一名患者为双侧冠状动脉-肺动脉瘘，另一名患者为左冠状动脉-肺动脉瘘。本研究表明，对于表现出提示动脉导管未闭的连续性杂音的患者，像我们患者中所见的二维和脉冲多普勒超声心动图检查结果应立即提醒医生，他可能正在处理一例冠状动脉瘘病例。
