Coronary to pulmonary artery fistula associated with significant coronary atherosclerosis / Ciddi koroner aterosklerozun eslik ettigi koroner arter fistulu olgusu.A 47-year-old man with history of smoking was admitted to our institution having exercise dyspnea and substernal chest pain for 3 months. He had no history of cardiac disease or trauma and his physical examination was normal. The 12-lead electrocardiogram electrocardiogram /elec·tro·car·dio·gram/ (-kahr´de-o-gram?) a graphic tracing of the variations in electrical potential caused by the excitation of the heart muscle and detected at the body surface. revealed T wave inversion in leads V4-V6. The exercise treadmill stress test showed ST depression of 1.5 mm in leads V1-6. Coronary angiogram an·gi·o·gram
An angiographic x-ray of blood vessels used in diagnosing pathological conditions of the cardiovascular system.//An x-ray of one or more blood vessels produced by angiography and used in diagnosing pathology in the cardiovascular demonstrated a coronary artery fistula fistula (fĭs`chlə), abnormal, usually ulcerous channellike formation between two internal organs or between an internal organ and the skin. (CAF CAF - constant applicative form ) originating from the proximal left anterior descending coronary artery Left anterior descending coronary artery (LAD)
One of the heart's coronary artery branches from the left main coronary artery which supplies blood to the left ventricle.
Mentioned in: Cardiac Catheterization superior to a critical atheromatous ath·er·o·ma
n. pl. ath·er·o·mas or ath·er·o·ma·ta
A deposit or degenerative accumulation of lipid-containing plaques on the innermost layer of the wall of an artery. stenosis (Fig. 1), draining into the pulmonary artery (Fig. 2. Video 1. See corresponding video/movie images at www.anakarder.com). The patient was planned to undergo coronary surgery.
Among coronary vessel anomalies CAF is the rare entity(1). Although it is suggested that coronary arterial atherosclerosis affects patients with CAF in the same way as in normal humans (2); the combination of fistula and significant obstruction of the same coronary artery is by far a less frequent phenomenon (2-3). Myocardial ischemia resulting from fistula steal phenomenon cannot be clinically distinguished from that of coronary atherosclerosis, if these conditions coexist in the same patient. Although noninvasive imaging may facilitate the diagnosis and identification of the origin and insertion of CAF, coronary angiography is necessary to show the presence of concomitant atherosclerosis (4).
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(1.) Wandwi WB, Mitsui N, Sueda T, Orihashi K, Sueshiro M, Azuma K, et al. Coronary artery fistula to bronchial artery on contralateral contralateral /con·tra·lat·er·al/ (-lat´er-al) pertaining to, situated on, or affecting the opposite side.
adj. side of coronary atherosclerosis and myocardial insufficiency. A case report. Angiology angiology /an·gi·ol·o·gy/ (an?je-ol´ah-je) the study of the vessels of the body; also, the sum of knowledge relating to the blood and lymph vessels.
n. 1996; 47: 211-3.
(2.) Rangel A, Chavez E, Badui E, Diaz R, Solorio S, Verdin R, et al. Case report of association of congenital coronary fistulae with coronary atherosclerosis. Rev Invest Clin 1995; 47: 481-6.
(3.) Castedo E, Oteo JF, Burgos R, Ugarte M, Cristobal C, Tebar E, et al. Coronary artery fistula as a bypass of a left anterior descending coronary artery stenosis. Ann Thorac Surg 1997; 64: 1813-4.
(4.) Gowda RM, Vasavada BC, Khan IA. Coronary artery fistulas: clinical and therapeutic considerations. Int J Cardiol 2006; 107: 7-10.
Address for Correspondence/Yazisma Adresi: Nesligul Yildirim Zonguldak Karaelmas University Faculty of Medicine Department of Cardiology 67600, Kozlu, Zonguldak, Turkey Phone: +90 372 261 01 69 E-mail: email@example.com
Nesligul Yildirim, Sait M. Dogan, Metin Gursurer, Mustafa Aydin
Department of Cardiology, Faculty of Medicine,
Zonguldak Karaelmas University, Zonguldak, Turkey