Abstract
We report the case of a 16-year-old young girl seen for precordial pain and stage II NYHA dyspnea. Clinical examination found a maximal systolodiastolic murmur in the left subclavicular. Lateral Q waves were noted on the electrocardiogram and echocardiography revealed a right coronary fistula draining in right atrium. CT scan confirmed the diagnosis. Patient was addressed to a specialized center for percutaneous closure of the fistula. In case of signs indicating coronary artery disease, the search for coronary anomalies should be systematic in children by using EKG and transthoracic echocardiography. In case of doubt, a second imaging such as the multislice Ct scan is performed. Coronary angiography has a dual diagnostic and therapeutic interest. The indications for treatment depend on the symptoms and the results of ischemia tests.
Highlights
Coronary fistulas are abnormal communications between a coronary artery and a heart chamber or large base vessel, thereby bypassing the myocardial capillary bed [1] [2]
We report the case of a 16-year-old young girl seen for precordial pain and stage II NYHA dyspnea
Patient was addressed to a specialized center for percutaneous closure of the fistula
Summary
Coronary fistulas are abnormal communications between a coronary artery and a heart chamber or large base vessel, thereby bypassing the myocardial capillary bed [1] [2]. These are rare defect and usually occur in isolation. The majority of these fistulas are congenital, they may occasionally be detected after cardiac surgery. Complications include “steal” from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrilla-. Thrombosis within the fistula is rare but may cause acute myocardial infarction, paroxysmal atrial fibrillation and ventricular arrhythmias [2]. We report a case of coronary cardiac fistula discovered during the exploration of exertion dyspnea in a 16-year-old girl
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