- 期刊
- OpenAccess
Severely Ectatic Left Circumflex Coronary Artery with Fistula to Coronary Sinus Presenting with Acute Coronary Syndrome
並列摘要
Introduction: Coronary artery fistulas are uncommon anomalies. They occur in 0.1-0.8% of patients undergoing coronary arteriography. The circumflex coronary arteriovenous fistulae (CAF) associated with aneurysmal dilatation and drainage into coronary sinus (CS) are even less common. We present a case of a 56-yearold male with an acute coronary syndrome who was found to have a tortuous and aneurysmal circumflex coronary artery terminating into the CS. Case report: A previously healthy 56-yearold male developed acute retrosternal chest pain while skiing. Physical examination revealed a grade II/VI continuous murmur at the left lower sternal border, but was otherwise unremarkable. Laboratory investigations revealed an elevated troponin and ST depression in the inferior leads on his electrocardiography. Coronary angiography showed a diffusely aneurysmal circumflex artery with a fistula to the CS. The patient underwent successful surgical ligation of the fistula. Conclusion: Our patient presented with an acute coronary syndrome caused by an uncommon form of coronary artery fistula. Conventional coronary angiography failed to fully define the anatomy of the fistula (origin, pathway, and outflow). Multidetector computed tomography was complementary to demonstrate the complex anatomy of the fistula. The fistula was surgically ligated and he remains well.
延伸閱讀
- Huang, P. C., Wu, W. L., Chen, C. Y., Chen, C. H., Chien, C. H., Lin, F. Y., & Chen, C. H. (2019). R-II C Type Single Right Coronary Artery: A Case Report. Journal of Radiological Science, 44(), 111-114. https://doi.org/10.6698/JRS.201908_44.0019
- Zehra, M., & Raza, S. (2015). Should We Use Left Internal Thoracic Artery to Graft Left Anterior Descending Coronary Artery at Re-operative CABG?. Journal of pioneering medical sciences, 5(3), 79-79. https://www.airitilibrary.com/Article/Detail?DocID=P20160812001-201509-201608120202-201608120202-79-79
- Wang, M. T., Huang, W. C., Kuo, F. Y., & Mar, G. Y. (2021). Double Total Occlusion of Bioresorbable Scaffold in a Young Patient with Coronary Artery Ectasia. Acta Cardiologica Sinica, 37(4), 438-441. https://doi.org/10.6515/ACS.202107_37(4).20210302A
- Binyousef, R. F., Habib, F. K., & Althobaiti, M. W. (2016). Left main coronary artery originating from the non-coronary sinus: A rare low-risk coronary anomaly. International Journal of Case Reports and Images (IJCRI), 7(3), xiii+195-197. https://doi.org/10.5348/ijcri-201604-CL-10097
- Wu, K. Y., & Lai, J. H. (2016). Traumatic Left Main Coronary Artery Dissection with Acute Myocardial Infarction after Chest Contusion. 內科學誌, 27(5), 261-266. https://doi.org/10.6314/JIMT.2016.27(5).05