title: Multiple coronary artery-left ventricular fistulas associated with hereditary hemorrhagic telangiectasia.
abstract: Coronary artery-left ventricular (LV) fistulas are extremely rare and can cause myocardial ischemia from coronary steal. We describe an elderly woman who presented with unstable angina from multiple and extensive coronary artery-LV fistulas. She also had clinical features suggestive of hereditary hemorrhagic telangiectasia (HHT). Association of coronary artery-LV fistulas with HHT has not been reported and can pose a management dilemma in view of the risks of extensive cardiopulmonary surgery and potential complications of myocardial ischemia, stroke, and brain abscess.
authors.affiliation: Department of Cardiology, University of Massachusetts-Saint Vincent Hospital, Worcester, MA 01608, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Jacob
authors.forename: S B
authors.initials: SB
authors.lastname: Goyal
authors.forename: L
authors.initials: L
authors.lastname: Pacifico
authors.forename: D H
authors.initials: DH
authors.lastname: Spodick
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000235:genetics*; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000235:genetics*; D003937:Diagnosis, Differential; D005260:Female; D006352:Heart Ventricles / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000000981:diagnostic imaging / Q000235:genetics*; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000235:genetics*