title: Myocardial ischemia secondary to a large coronary-pulmonary fistula--a case report.
abstract: Coronary-pulmonary fistulas are rare. The majority of these fistulas arise from the left anterior descending or the right coronary arteries; the circumflex coronary artery is rarely involved. The majority of patients are asymptomatic, but heart failure, angina, myocardial infarction, endocarditis, and dyspnea have rarely been reported. The management is controversial and recommendations are based on anecdotal cases or very small retrospective series. A case of a 62-year-old female is reported who presented with chest pain and was found to have myocardial ischemia on SPECT sestamibi. Cardiac catheterization revealed no obstructive coronary artery disease and a large coronary pulmonary fistula communicating from the left circumflex coronary artery to the left pulmonary artery.
authors.affiliation: Division of Cardiology, University of South Alabama College of Medicine, Mobile 36617, USA.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Umaña
authors.forename: Clara V
authors.initials: CV
authors.lastname: Massey
authors.forename: Jack A
authors.initials: JA
authors.lastname: Painter
mesh_terms: D001159:Arterio-Arterial Fistula / Q000150:complications* / Q000000981:diagnostic imaging*; D006328:Cardiac Catheterization; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology*; D011651:Pulmonary Artery / Q000002:abnormalities; D011877:Radionuclide Imaging