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.
Department of Cardiology, Saga National Hospital, Japan.
Shin-ichiro
S
Ozeki
Toshinori
T
Utsunomiya
Tomoya
T
Kishi
Takashi
T
Tokushima
Shinsuke
S
Tsuji
Shuzo
S
Matsuo
Masafumi
M
Natsuaki
Tsuyoshi
T
Ito
Katsusuke
K
Yano
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