[Apical hypertrophic myocardiopathy and multiple fistulae between the coronary vessels and the left ventricle].
A male patient presented with symptoms of angor under effort. Echocardiography and angiocardiography revealed apical hypertrophic myocardiopathy, associated with multiple fistulas connecting the anterior descending coronary artery and right coronary artery with the cavity of the left ventricle, as demonstrated by coronariography. We comment on the hypothesis that support a causal relationship between the two anomalies, microfistulas being the possible cause of the reactive hypertrophy through the induction of a coronary steal phenomenon with local ischemia; alternatively, the myocardiopathy itself might be the cause of microfistulas formation by inducing an anomaly in the Thebesius venous system. A pathogenic relationship is suggested between the syndrome of angor and these two rare pathological entities.
Servicio de Cardiología, Hospital Clínico Universitario de Valencia.
J V
JV
Monmeneu
V
V
Bodí
J
J
Sanchís
F J
FJ
Chorro
R
R
Llopis
L
L
Insa
V
V
López Merino
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003327:Coronary Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D005402:Fistula / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006331:Heart Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D009566:Nitrates / Q000627:therapeutic use; D012074:Remission Induction
D002121:Calcium Channel Blockers; D009566:Nitrates
Miocardiopatía hipertrófica apical y múltiples fístulas entre coronarias y ventrículo izquierdo.