Echocardiographic Diagnosis of Incidentally Found Left Coronary Artery to Pulmonary Artery Fistula in an 11-Year-Old Girl.
We report on a healthy 11-year-old girl who presented to our facility with sudden onset of fainting in a strenuous running course. Transthoracic echocardiography at short-axis view showed a diastolic flow into the main pulmonary artery (PA). The diagnosis of left anterior descending artery (LAD) to PA fistula was documented by cardiac computed tomography and catheterization. Interventional therapy of LAD to the main PA fistula was not performed because of no evidence of myocardial ischemia or significant hemodynamic change. Presently, the patient remains asymptomatic. Coronary fistula with an incidence of about 0.1-0.8% is very rare and may be undetected, particularly in pediatric patients without cardiac murmur. We herein describe the diagnostic approach and discuss the current treatment modalities.
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung; ; Department of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan;
Bo-Hau
BH
Chen
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung;
Chu-Chuan
CC
Lin
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung; ; National Yang-Ming University, Taipei; ; Shu-Zen College of Medicine and Management, Kaohsiung;
Ken-Pen
KP
Weng
Department of Pediatrics, Kaohsiung Armed Forces General Hospital;
Huang-Wei
HW
Wu
Department of Pediatrics, Zuoying Branch of Kaohsiung Armed Forces General Hospital;
Jen-Hung
JH
Chien
Department of Pediatrics, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.
Shih-Ming
SM
Huang
Coronary angiography; Coronary artery fistula; Echocardiography