Coronary artery fistula: diagnostic role of transthoracic and transesophageal echocardiography.
Congenital coronary artery fistulas (CAFs) are rare. Some patients develop symptoms of congestive heart failure secondary to a large left-to-right shunt or myocardial ischemia from coronary artery steal in the first few years after birth. After the second decade the frequency of symptoms and complications increase. We report a case of CAF originating from the circumflex artery and draining into the coronary sinus, associated with left main coronary aneurysm. Transtho-racic and transesophageal echocardiography approach showed the origin, course, and drainage site of the CAF. This case represents a typical sample of this rare anomaly and puts into evidence the essential role of echocardiography to define and complete the angiographic diagnosis.
Section of Cardiovascular Disease, Department of Applied Experimental Medicine, University of Brescia, Brescia, Italy enrico.vizzardi@tin.it.
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Vizzardi
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D'Aloia
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Zanini
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Antonioli
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Chiari
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Fiorina
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Raddino
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Nodari
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Dei Cas
D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D005402:Fistula / Q000150:complications / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008875:Middle Aged