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.
Vizzardi
E
E
Section of Cardiovascular Disease, Department of Applied Experimental Medicine, University of Brescia, Brescia, Italy enrico.vizzardi@tin.it.
D'Aloia
A
A
Zanini
G
G
Antonioli
E
E
Chiari
E
E
Fiorina
C
C
Raddino
R
R
Nodari
S
S
Dei Cas
L
L
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