Coronary arteriovenous fistula presenting as chronic pericardial effusion.
In August 1998, the patient, a 75-year-old woman, was diagnosed with pericardial effusion (PE) during an investigation of cardiomegaly. The PE disappeared after the administration of diuretics, but in February 1999, shortness of breath and general fatigue developed, and PE was again present. Diagnostic pericardiocentesis revealed bloody fluid. Chest computed tomography revealed a markedly expanded and tortuous right coronary artery (RCA). Coronary angiography (CAG) confirmed a RCA-coronary sinus fistula, and there was a significant step-up of O2 saturation at the right atrium. Cardiac tamponade developed soon after CAG, so the patient underwent surgical closure of the CAVF. Although a bleeding point was not identified, the PE was disappeared after operation. Histopathologically, parts of the wall of the fistula were quite thin and erythrocytes and lymphocytes had infiltrated the pericardial space. The clinical course and the findings indicate that the CAVF caused chronic PE.
Ozeki
Shin-ichiro
S
Department of Cardiology, Saga National Hospital, Japan.
Utsunomiya
Toshinori
T
Kishi
Tomoya
T
Tokushima
Takashi
T
Tsuji
Shinsuke
S
Matsuo
Shuzo
S
Natsuaki
Masafumi
M
Ito
Tsuyoshi
T
Yano
Katsusuke
K
D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002305:Cardiac Tamponade / Q000209:etiology; D002908:Chronic Disease; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006801:Humans; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed