title: Coronary arteriovenous fistula secondary to percutaneous coronary intervention of chronic total occlusion.
abstract: This is a case report of a 61-year-old female presenting with ongoing chest pain in the setting of an NSTEMI with lateral ST-T changes. On attempting to open the left circumflex (LCX), it resulted in a proximal LCX dissection. The patient remained stable with no further chest pain. She was treated with IV Eptifibatide for 48 hours and restudied in 72 hours. Repeat coronary angiography showed a marginally improved proximal dissection plane with a coronary AV fistula. She was managed conservatively and discharged with a non-invasive assessment in 8 weeks. The patient had a negative stress echocardiogram and was managed with maximal medical therapy.
authors.affiliation: Manning Rural Referral Hospital, Cardiovascular Division, Department of Medicine, Hunter New England Health Services, Taree, NSW 2430, Australia ; Conjoint Senior Lecturer, University of New England, School of Rural Medicine, Armidale, NSW 2351, Australia ; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.
authors.forename: Seshasayee
authors.initials: S
authors.lastname: Narasimhan