Coronary artery fistulas as a rare cause of heart failure and ventricular arrhythmia, associated with multiple large vessel fistulas

Bryam López; Milagros Batallanos

doi:10.1016/j.radcr.2023.02.020

Coronary artery fistulas as a rare cause of heart failure and ventricular arrhythmia, associated with multiple large vessel fistulas

Radiol Case Rep. 2023 Mar 5;18(5):1848-1851. doi: 10.1016/j.radcr.2023.02.020. eCollection 2023 May.

Authors

Bryam López¹, Milagros Batallanos¹

Affiliation

¹ Department of Cardiology, National Hospital Edgardo Rebagliati Martins, Avenida Edgardo Rebagliati 490, Jesús María, Lima 15072, Perú.

Abstract

Coronary artery fistulas are abnormal connections between the coronary arteries with a heart chamber or any of the major blood vessels. Fistulous connections between systemic arteries and pulmonary vessels are even less frequent. We present a case of a 71-year-old man with symptoms of dyspnea, exercise intolerance, and ventricular arrhythmia who attended the emergency department. Coronary angiography revealed bilateral coronary fistulas drained into the pulmonary circulation. Computed tomography angiography revealed the presence of fistulas arising from the descending aorta, right internal mammary artery, and subclavian arteries, all these drained into the pulmonary circulation. Due to the rarity of the disease, there are no international guidelines for the management of coronary fistulas and the treatment is controversial. Coronary artery fistula is a rare pathology that should be included in the differential diagnosis of heart failure and ventricular arrhythmia.

Keywords: CAF, Coronary artery fistula; Coronary angiography; Coronary artery fistula; EF, Ejection fraction; Heart failure; NSVT, Non-sustained ventricular tachycardia; Ventricular arrhythmia.

Publication types

Case Reports