Sudden death in a patient with multiple left anterior descending coronary artery fistulas to the left ventricle

A coronary artery fistula (CAF) is an abnormal communication between a coronary artery and a cardiac chamber or a great vessel. CAFs are rare based on coronary arteriography and when found they most often empty into the right ventricle and atrium and less often into the high pressure, low compliance left ventricle (LV). A patient who presented with atypical chest pain and was found to have multiple small CAFs originating from the ramus intermedius coronary artery and emptying into the LV is presented. This case highlights the challenges in providing an appropriate therapy for multiple small CAFs emptying into the LV.

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An Anomalous Left Anterior Descending Artery

Ibrahim Medical College Journal ◽

10.3329/imcj.v4i1.5934 ◽

2010 ◽

Vol 4 (1) ◽

pp. 34-36

Author(s):

M Maksumul Haq ◽

M Mahboob Mansur ◽

Syed Dawood Md Taimur

Keyword(s):

Coronary Artery ◽

Sudden Death ◽

Diagnostic Testing ◽

Coronary Angiogram ◽

Cardiac Anomalies ◽

Non Invasive ◽

Left Anterior Descending Artery ◽

Coronary Artery Fistulas

Coronary artery fistulas can go undetected as they tend to remain clinically silent. Larger fistulas can end up with sudden death, ischemia, endocarditis or CCF. However, these are detected incidentally during non-invasive or invasive diagnostic testing for unrelated symptoms. This report describes such a case in a 56 year old male while undergoing a coronary angiogram following an anteroseptal infarction three weeks prior to the procedure. The fistula arose from the proximal left LAD and was seen in all views. It is important for cardiologists to remember about the possibility of such uncommon possibilities.Ibrahim Med. Coll. J. 2010; 4(1): 34-36Indexing words: Cardiac anomalies; angiogram; fistula.

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Bilateral Coronary Artery Fistulas Communicating With Main Pulmonary Artery and Left Ventricle

Angiology ◽

10.1177/0003319706292572 ◽

2007 ◽

Vol 58 (1) ◽

pp. 118-121 ◽

Cited By ~ 2

Author(s):

Won Seok Cheon ◽

Eung Ju Kim ◽

Seong Hwan Kim ◽

Young Jin Choi ◽

Chong Yun Rhim

Keyword(s):

Coronary Artery ◽

Left Ventricle ◽

Pulmonary Artery ◽

Main Pulmonary Artery ◽

Coronary Artery Fistulas

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Bilateral Coronary Artery Fistulas and Left Ventricle Noncompaction in a Neonate: Diagnosis and Management

Pediatric Cardiology ◽

10.1007/s00246-011-9938-3 ◽

2011 ◽

Vol 32 (6) ◽

pp. 815-817 ◽

Cited By ~ 4

Author(s):

Nguyenvu Nguyen ◽

Cynthia K. Rigsby ◽

Katheryn Gambetta ◽

Sunjay Kaushal

Keyword(s):

Coronary Artery ◽

Left Ventricle ◽

Diagnosis And Management ◽

Coronary Artery Fistulas

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Acute coronary syndrome in a patient with multiple coronary artery fistulas draining from the left anterior descending artery into the left ventricle – 2-year follow-up

Advances in Interventional Cardiology ◽

10.5114/pwki.2011.21195 ◽

2011 ◽

Vol 1 ◽

pp. 87-90

Author(s):

Beata Wożakowska-Kapłon ◽

Paweł Salwa ◽

Maciej Młodnicki ◽

Przemysław Dąbkowski

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Left Ventricle ◽

Coronary Syndrome ◽

Left Anterior Descending Artery ◽

Coronary Artery Fistulas

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Diffuse Coronary Artery Fistula Leading to Syncope and Treated with Transcatheter Coil Occlusion and a Defibrillator: A Case Report

Medical Principles and Practice ◽

10.1159/000500309 ◽

2019 ◽

Vol 28 (5) ◽

pp. 493-496 ◽

Cited By ~ 1

Author(s):

Murat Meric ◽

Serkan Yuksel

Keyword(s):

Coronary Artery ◽

Ventricular Fibrillation ◽

Left Ventricle ◽

Coronary Artery Fistula ◽

Left Ventricular ◽

Cardioverter Defibrillator ◽

Coil Occlusion ◽

Coronary Artery Fistulas ◽

Clinically Significant ◽

Nuclear Scanning

Objectives: Coronary artery fistulas connecting coronary arteries to cardiac cavities are rare but clinically significant anomalies. Clinical Presentation and Intervention: A 47-year-old male patient presented with syncope. Left ventricular dysfunction was detected on echocardiography. Extensive coronary fistulas draining into the left ventricle were found on coronary angiography. Ventricular fibrillation was induced on electrophysiology study. Because of the induction of ventricular fibrillation, extensive fistulas, and presence of other risk factors, an implantable cardioverter defibrillator was implanted. After the detection of ischemia by nuclear scanning, microcoil occlusion of the fistula was performed. Conclusion: The present case describes extensive fistulas complicated with fatal ventricular arrhythmias due to ischemia and left ventricle dysfunction. A cardioverter defibrillator was implanted to prevent sudden cardiac death.

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