Heart failure due to coronary fistulas from the right and left coronary circulation into the right atrium.
A patient with a history of hypertension presented with worsening shortness of breath, fatigue, and productive cough with blood-tinged sputum. A continuous murmur was heard at the lower sternum and chest X-ray showed mild cardiomegaly. A dilated right atrium with moderately elevated pulmonary artery pressures was detected by transthoracic echocardiogram. Stress ECG did not reveal any inducible ischemia. Cardiac catheterization demonstrated an RCA aneurysm with fistula to the right atrium and a circumflex artery fistula to the right atrium, which were corrected by surgery.
Yeboah
Joseph
J
Heart and Vascular Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Akosah
Kwame
K
Ailawadi
Gorav
G
D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D025401:Echocardiography, Stress; D017548:Echocardiography, Transesophageal; D005402:Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006325:Heart Atria / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery