Abstract
Abstract A 75-years-old man presented in our cardiology service with easy fatigue, shortness of breath and palpitations for last two months. His ECG showed atrial fibrillation and LBBB. Until now he was not anticoagulated. We performed first transthoracic echocardiography and found reduced EF - 33%, with global hypokinesia of the LV and LV hypertrophy. Many atrial and ventricular septal perforating arteries. Dilated right coronary sinus. Mild mitral, aortic and tricuspid regurgitation with no pulmonary hypertension. We identified a strongly curved vascular structure in right atrioventricular groove. We performed coronary CT angiography and found abnormal coronary vessels "Cor Medusae" (coronary arteriovenous fistula). Giant RCA - 31mm in diameter with many branches, one of them has comuniction with left atrium and one of the other comunicate with truncus pulmonalis. LAD, LCx and D1 came from truncus pulmonalis. A very rare congenital condition. On a cardiology discussion we decided to apply conservative treatment. Abstract P183 Figure. CT reconstruction cor medusae
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