Abstract
Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA), and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.
Highlights
Coronary artery fistula (CAF) is defined as an anomalous connection between a coronary artery and a major vessel or a cardiac chamber
We present a case of CAF with coronary anomaly
Epidemiology The incidence of coronary anomalies varies between 0.6% and 1.5% of patients undergoing invasive cardiovascular imaging [3, 4]
Summary
Coronary artery fistula (CAF) is defined as an anomalous connection between a coronary artery and a major vessel or a cardiac chamber. It is an uncommon form of congenital heart disease. Most of the coronary anomalies are incidental findings during angiographic evaluation for coronary vascular disorders Majority of these fistulas arise from the left anterior descending artery or from the right coronary artery [1]. Most of these patients are asymptomatic, but heart failure, angina, myocardial infarction, coronary steal, endocarditis, and dyspnea have been reported in some cases [2].
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