CORONARY CAMERAL FISTULA PDF

Metrics details. A coronary cameral fistula is a rare connection between a coronary artery and a cardiac chamber or vein bypassing the cardiac capillary bed system. Most of these fistulae are congenital and solitary, although they can be acquired and multiple. An echocardiogram demonstrated a large coronary cameral fistula involving his left coronary artery and his left ventricle.

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Coronary cameral fistula is a rare entity and is characterized by an abnormal communication between coronary artery and a cardiac chamber. It is usually congenital and asymptomatic in majority of patients. If symptomatic the patients usually present in childhood. We present a case of year-old male who presented with anginal chest pain and dyspnea on exertion for last 1 year. His exercise treadmill test was positive for ischemic changes and ECG-gated contrast enhanced CT was done for further evaluation.

CT showed a large right coronary artery to right atrium fistula. It also ruled out any coronary atherosclerosis as reason for chest pain and ischemic symptoms on exercise treadmill test. The fistula was successfully closed by surgery and there was resolution of chest pain and dyspnea. Coronary cameral fistulas CCFs are rare and are characterized by abnormal communication between coronary artery CA and cardiac chamber that usually results from aberrancy of normal embryological development.

We here present a rare case of symptomatic CCF diagnosed by electrocardiogram ECG -gated multidetector computed tomography MDCT with resolution of the symptoms following successful repair. A year-old non-smoker, male, with no significant past medical history, presented to the outpatient clinic of our hospital with progressive dyspnea on exertion and anginal chest pain for one year.

He reported having an echocardiogram in an outside hospital that showed a tortuous vascular channel along the right atrium concerning for CA aneurysm.

The cardiac and respiratory exam was unremarkable. The cardiac apex was not displaced, and there was no murmur. His exercise treadmill test was positive for ischemic changes with accompanying chest pain. Prior to image acquisition, the patient received oral metoprolol for heart rate control and also received 0. CT also showed the absence of any coronary atherosclerosis.

Three-dimensional volume rendered VR images accurately depicts the relationship of the enlarged right CA to the aorta, right-sided chambers, and the CAs.

Since the patient was symptomatic, surgical closure of the fistula was done. The postsurgical course was uneventful with resolution of chest pain and dyspnea. The left CA block arrow in b is arising normally from the left coronary cusp and is a normal caliber artery.

Three-dimensional volume rendered VR computed tomography images c and d give an accurate depiction of the course of fistula and its relation to adjacent vascular structures. These fistulae are asymptomatic in the majority of cases and are detected incidentally.

The presence or absence of symptoms may be related to the size of the fistula and the site of origin and termination of the fistula. These fistulae may cause angina by coronary steal phenomenon and diastolic overload. Classically, diagnostic coronary angiogram has been used for diagnosis and has been considered as a gold standard for diagnosis[ 4 ] but with advances in noninvasive cardiac imaging, these fistulae are being increasingly diagnosed by MDCT or echocardiogram.

Although there is no consensus on treatment of choice of symptomatic fistulae due to its rarity; surgical repair, catheter closure and medical management have been successfully tried. Arterio-luminal subtype, as in our case can be successfully closed by surgery, whereas arteri-sinusoidal type is less amenable to surgery and use of beta-blocker is described in the literature. Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology Information , U.

Journal List Heart Views v. Heart Views. Saboo , 1, 3 Gunjan Garg , 2 and Michael L. Steigner 1. Sachin S. Michael L. Author information Copyright and License information Disclaimer. Address for correspondence: Dr. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC.

Abstract Coronary cameral fistula is a rare entity and is characterized by an abnormal communication between coronary artery and a cardiac chamber. Keywords: Chest pain, computed tomography, congenital, coronary fistula. CASE REPORT A year-old non-smoker, male, with no significant past medical history, presented to the outpatient clinic of our hospital with progressive dyspnea on exertion and anginal chest pain for one year.

Open in a separate window. Figure 1. Coronary artery fistulas in adults: Incidence, angiographic characteristics, natural history. Cathet Cardiovasc Diagn. Padfield GJ. A case of coronary cameral fistula. Eur J Echocardiogr. Coronary artery-left ventricular fistula with angina pectoris. Am Heart J. Qureshi SA. Coronary arterial fistulas. Orphanet J Rare Dis. MDCT of congenital coronary artery fistulas. Multimodality non-invasive imaging of a coronary cameral fistula.

Eur Heart J Cardiovasc Imaging. Coronary artery-left ventricular fistula. A systematic review on diagnostic accuracy of CT-based detection of significant coronary artery disease. Eur J Radiol. Support Center Support Center. External link. Please review our privacy policy.

ESIT LCA-D PDF

Symptomatic Coronary Cameral Fistula

Coronary cameral fistula is a rare entity and is characterized by an abnormal communication between coronary artery and a cardiac chamber. It is usually congenital and asymptomatic in majority of patients. If symptomatic the patients usually present in childhood. We present a case of year-old male who presented with anginal chest pain and dyspnea on exertion for last 1 year. His exercise treadmill test was positive for ischemic changes and ECG-gated contrast enhanced CT was done for further evaluation.

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Transcatheter occlusion of giant congenital coronary cameral fistulae: a case series

NCBI Bookshelf. Mohamed K. Mansour ; Shivaraj Nagalli. Authors Mohamed K. Mansour 1 ; Shivaraj Nagalli 2. Coronary artery fistulae are abnormal communications between the coronary arteries and adjacent structures. They include abnormal communications between the coronary arteries and cardiac chambers, referred to as coronary cameral fistulae or abnormal communications between the coronary arteries and other vessels referred to as coronary arteriovenous malformations.

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