Coronary artery fistula diagnosed by transthoracic Doppler echocardiography.
A 47-year-old Malay woman complained of an episode of shortness of breath after a shower. There was no previous complaint of shortness of breath or chest pain. Physical examination revealed a wide pulse pressure. Blood pressure was 160/66 mmHg, and heart rate was 77/minute and regular. What was initially thought to be a loud pansystolic murmur was heard over the precordium. Electrocardiography showed left ventricular hypertrophy with a volume overload pattern. Transthoracic Doppler echocardiography revealed a right coronary artery-right ventricular fistula, arising from the right coronary artery and draining into the right ventricular cavity.
Chee
T S
TS
Division of Cardiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889. tschee@singnet.com.sg
Tan
P J
PJ
Koh
S K
SK
Jayaram
L
L
D003324:Coronary Artery Disease / Q000175:diagnosis*; D003330:Coronary Vessel Anomalies / Q000175:diagnosis*; D003331:Coronary Vessels / Q000378:metabolism; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D005402:Fistula / Q000151:congenital* / Q000175:diagnosis; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D008875:Middle Aged