title: [Multiple coronary artery-left ventricle fistulas in a patient with apical hypertrophic cardiomyopathy: an unusual cause of angina pectoris].
abstract: A 50 year-old man had a history of crescendo exertional angina. Echocardiographic and electrocardiographic findings were typical of apical hypertrophic cardiomyopathy. Selective coronary angiography showed no atherosclerotic lesions, but there was a stream of dye into the left ventricle, via a tiny plexus of intramural vessels, from the distal third of the anterior descending coronary artery. The origin of myocardial ischemia has been related to a "steal" phenomenon, while this vascular anomaly could represent a disorder of the thebesian system, possibly due to the "disarray" of myocardial cells typical of hypertrophic cardiomyopathy.
authors.affiliation: Dipartimento di Cardiologia, Ospedale S. Carlo, Potenza.
authors.forename: P
authors.initials: P
authors.lastname: Lisanti
authors.forename: W
authors.initials: W
authors.lastname: Serino
authors.forename: M
authors.initials: M
authors.lastname: Petrone
mesh_terms: D000787:Angina Pectoris / Q000209:etiology*; D000792:Angiography; D001158:Arteries; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D017023:Coronary Angiography; D003331:Coronary Vessels; D004452:Echocardiography; D004562:Electrocardiography; D005402:Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged
vernacular_title: Fistole multiple coronaria-ventricolo sinistro in paziente con cardiomiopatia ipertrofica apicale: causa insolita di angina pectoris.