[Multiple coronary fistulas to the left ventricle. An unusual cause of myocardial ischemia].
Diffuse communications between the left coronary artery and the left ventricular cavity were found in a 54-years-old man presenting with angina pectoris and reversible ischemia documented on stress Thallium scintigraphy. During atrial pacing the patient experienced chest pain which was accompanied by lactate production. Atenolol, but not nifedipine, did ameliorate the symptoms. The anatomical types and the embriogenesis of coronary microfistulas along with possible mechanisms of ischemia are discussed.
G
G
Piovaccari
G
G
Melandri
A
A
Marzocchi
D
D
Scarfoglio
M
M
Sanguinetti
B
B
Magnani
D000787:Angina Pectoris / Q000188:drug therapy / Q000209:etiology; D000792:Angiography; D001262:Atenolol / Q000627:therapeutic use; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology*; D003331:Coronary Vessels; D005402:Fistula / Q000150:complications*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged
D001262:Atenolol
Fistole coronariche multiple dirette al ventricolo sinistro. Una causa insolita di ischemia miocardica.