Increased myocardial ischemia during nitrate therapy: caused by multiple coronary artery-left ventricle fistulae?
We present the case of a 54-year-old man who had crescendo angina during nitrate therapy. Selective coronary angiograms showed no atherosclerotic lesions, but did show plexuses of intramural vessels that connected the distal thirds of the left and right coronary systems with the left ventricle. The cause of our patient's increased myocardial ischemia during nitrate therapy may have been the coronary "steal" phenomenon.
Heper
Gulumser
G
Department of Cardiology, SSK Ihtisas Hospital, Turkey. heperg@hotmail.com
Kose
Sedat
S
D009202:Cardiomyopathies / Q000150:complications*; D003327:Coronary Disease / Q000150:complications*; D005402:Fistula / Q000150:complications*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000209:etiology*; D009566:Nitrates / Q000009:adverse effects*; D016157:Vascular Fistula / Q000150:complications*
D009566:Nitrates