Coronary Cameral Fistula

Abstract

Coronary Cameral Fistulas (CCFs) are rare arteriovenous malformations, defined as a connection between a coronary artery and a cardiac chamber or any segment of the systemic or pulmonary circulation. These may be congenital or acquired, and show a low incidence in both angiographic studies, and the general population. The presentation of CCFs varies depending upon their size and location. These can be majorly asymptomatic or show symptoms and complications like congestive heart failure, myocardial infarction, and bacterial endocarditis. Although percutaneous closure with embolisation can be done, surgical closure of CCF is a gold standard of treatment. The authors reported a case of a 57-year-old male who presented with exertional chest pain and dyspnea. Coronary angiography revealed the presence of dilated tortuous Left Main Coronary Artery (LMCA), Left Anterior Descending artery (LAD), Left Circumflex artery (LCX) and CCF between LAD to Right Ventricle (RV), Obtuse Marginal (OM) to RV and Posterior Left ventricular Branch (PLB) to RV. No significant obstructive coronary artery disease was present. Coronary artery calcium score was 15. The patient was managed conservatively with antiplatelets, statin, and heparin and responded well to the treatment.