title: Congenital giant right coronary artery aneurysm with fistula to the coronary sinus and persistent left superior vena cava in an old woman.
abstract: The combination of coronary arteriovenous fistula to the coronary sinus (CS), dilatation of the entire length of coronary artery, coronary aneurysm and persistent left superior vena cava (PLSVC) is very rare. We present the case of a 63-year-old female admitted for dyspnea on exertion, orthopnea, and facial edema. Echocardiography detected a giant coronary artery with shunt flow, dilated CS and PLSVC and a coronary angiography reaffirmed these findings. The calculated ratio of pulmonary blood flow to systemic blood flow by cardiac catheterization was 1.53. After multidisciplinary review considering old age, hypoactivity due to underlying Parkinsonism and relatively small amount of shunt flow, medical therapy was chosen. The patient remained asymptomatic for 10 months after discharge without intervention.
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Soo-Yong
authors.initials: SY
authors.lastname: Lee
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.forename: Hye-Ju
authors.initials: HJ
authors.lastname: Yeo
authors.forename: Chang-Bae
authors.initials: CB
authors.lastname: Sohn
authors.forename: Dong-Cheul
authors.initials: DC
authors.lastname: Han
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.forename: June-Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Kook-Jin
authors.initials: KJ
authors.lastname: Chun