Catheter-based management for the congenital coronary arteriovenous fistula indicated by the stress 99mTc-MIBI SPECT.
A 10-year-old boy, who had suffered Kawasaki disease 7 years ago, presented chest pain, pale face, and cold sweating in the stress (99m)technetium-methoxyisobutylisonitrile ((99m)Tc-MIBI) single-photon emission computed tomography (SPECT), which showed reversible perfusion abnormality indicative of myocardial ischemia involving the right coronary artery. Angiography identified congenital coronary arteriovenous fistula (CAVF) from the right coronary artery to the main pulmonary artery, to which the patient's symptoms and signs of myocardial ischemia, by means of coronary steal phenomenon that entails reversible perfusion abnormality in the stress (99m)Tc-MIBI SPECT, could be ascribed. The penny shall finally be dropped without sudden cardiac event after coaxial transarterial coil occlusion on this boy with the congenital CAVF that is indicated significantly by the stress (99m)Tc-MIBI SPECT.
Lee
Meng-Luen
ML
Peng
Jui-Wen
JW
Hung
Guang-Uei
GU
D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D006328:Cardiac Catheterization / Q000379:methods; D002648:Child; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging / Q000628:therapy; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D013349:Subclavian Steal Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D017256:Technetium Tc 99m Sestamibi