title: Echocardiographic diagnosis of coronary artery fistula in both dizygotic twin brothers: environmental mechanism?
abstract: A congenital coronary artery fistula (CAF) is a rare form of heart disease in which a coronary artery and a cardiac chamber or another vascular structure communicate. CAF could worsen ventricular perfusion and function, favoring ventricular ischemia and arrhythmias. To our knowledge, this is the first report of CAF, draining in the pulmonary artery, in two asymptomatic dizygotic twin brothers, diagnosed by echocardiography. Dizygotic twins are siblings with different genes exposed to the same environmental experience during the pregnancy. The occurrence of CAF (with similar instrumental findings) in both twin brothers could depend on a poorly identified environmental factor during pregnancy.
authors.affiliation: aDivision of Cardiology, Fatebenefratelli Hospital bPediatric Practitioner, Benevento, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caputo
authors.forename: Nunziatina
authors.initials: N
authors.lastname: Sorice
authors.forename: Renato
authors.initials: R
authors.lastname: Sansone
authors.forename: Domenico
authors.initials: D
authors.lastname: Simeone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Caruso
authors.forename: Rocco
authors.initials: R
authors.lastname: Russo
authors.forename: Nicola
authors.initials: N
authors.lastname: Cicchella
authors.forename: Annamaria
authors.initials: A
authors.lastname: Izzo
authors.forename: Carmen
authors.initials: C
authors.lastname: Saviano
authors.forename: Antonella
authors.initials: A
authors.lastname: Casani
authors.forename: Quirino
authors.initials: Q
authors.lastname: Ciampi
authors.forename: Bruno
authors.initials: B
authors.lastname: Villari
mesh_terms: D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000209:etiology; D004200:Diseases in Twins / Q000000981:diagnostic imaging* / Q000209:etiology; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D012307:Risk Factors; D014429:Twins, Dizygotic