[Syncope with cardiac arrest in a 30-year-old woman].
METHODS
A 30-year-old woman presented with a cardiac arrest, which spontaneously converted into a regular sinus rhythm. The patient had no prior history of cardiovascular diseases. On admission, the cardiovascular clinical examination of this young female was regular.


METHODS
On admission, discrete inferior repolarisation changes were documented which were slightly progressive during the next day. Electrophysiologic examination of the heart was regular, angiography showed a coronary fistula and an atypical descense of the circumflex artery from the right coronary artery.


METHODS
Right coronary artery fistula to the right ventricle. Atypical descense of the circumflex artery from the right coronary artery.


METHODS
During hospitalisation no arrhythmias or pauses were revealed. The patient underwent cardiac pacemaker implantation. We plan a transcatheter closure of the fistula.


CONCLUSIONS
Coronary fistulas are a rare cause of cardiac arrhythmias. Angiography performed at an early stage is therefore crucial in the initial assessment of a young adult presenting with cardiac arrest and subsequent changes in the ECG, as a small proportion may have coronary vascular abnormalities. The occlusion of the fistula by transcatheter or cardiac surgery is appropriate, especially as the risks of the interventions are limited.
Lottermoser
K
K
Medizinische Univ.- Poliklinik, Universitätsklinikum, Bonn. katlori@hotmail.com
Grohé
C
C
Omran
H
H
Walger
P
P
D000328:Adult; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D010138:Pacemaker, Artificial; D013575:Syncope / Q000209:etiology* / Q000517:prevention & control