title: Echocardiographic demonstration of coronary artery to left ventricle fistulas: case report and review of the literature.
abstract: We describe the case of a 45-year-old female patient with coronary fistulas arising from both the left and right coronary artery system and emptying in the left ventricle. Only sporadically do coronary artery fistulas drain into the left ventricle. In our patient, the most likely explanation of the fistulous communications was a congenital cause. We review the literature on coronary cameral fistulas and discuss the etiology of the diagnostic findings. Small coronary artery fistulas are generally well-tolerated and should impose no significant restriction on daily routine and activities. Nevertheless, small fistulas may under certain conditions produce a "steal" phenomenon and shunt blood flow away from the myocardial capillary network, causing ischemia.
authors.affiliation: Cardiology Department, Heraklion University Hospital, Crete, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Maragkoudakis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Patrianakos
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Kallergis
authors.forename: Fragkiskos
authors.initials: F
authors.lastname: Parthenakis
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006439:Hemodynamics; D006801:Humans; D008790:Metoprolol / Q000008:administration & dosage*; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000151:congenital / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D008790:Metoprolol