Multiple coronary artery-left ventricular microfistulae in a patient with apical hypertrophic cardiomyopathy: a demonstration by transthoracic color Doppler echocardiography.
Among the congenital coronary artery fistulae, multiple coronary artery microfistulae arising from the left and right coronary artery and emptying into the left ventricle are very rare and little is known of their anatomic and clinical features, especially in apical hypertrophic cardiomyopathy. A 67-year- old woman was referred for the evaluation of chest pain at exertion, and shortness of breath. Electrocardiographic and echocardiographic findings were typical of apical hypertrophic cardiomyopathy. Coronary arteriography showed normal epicardial coronary arteries, but multiple coronary artery-left ventricular microfistulae arising from the left and right coronary arteries. Transthoracic color Doppler echocardiography, using a high frequency transducer with a low Nyquist limit, demonstrated multiple coronary artery-left ventricular microfistulae just beneath the apical impulse window.
Hong
Geu-Ru
GR
Cardiology Division, Cardiovascular Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Choi
Seong Hun
SH
Kang
Seok-Min
SM
Lee
Moon Hyung
MH
Rim
Se-Joong
SJ
Jang
Yang Soo
YS
Chung
Nam Sik
NS
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006352:Heart Ventricles; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis