Non-invasive recognition of generalized coronary arteriosystemic fistulae by contrast echocardiography and multidetector CT

Coronary artery fistulae, including generalized coronary arteriosystemic fistulae, are usually identified incidentally during invasive coronary angiographies. Generalized or multiple coronary arteriosystemic fistulae arise from all three major coronary arteries draining into the left ventricular cha...

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Bibliographic Details
Published in:The International Journal of Cardiovascular Imaging 2011-06, Vol.27 (5), p.749-753
Main Authors: Woo, Jeong Joo, Koh, Young Youp, Ha, Sung Il, Chang, Kyoung Sig, Hong, Soon Pyo
Format: Article
Language:English
Subjects:
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Cardiac Imaging
Cardiology
Contrast Media
Coronary Angiography - methods
Coronary Vessel Anomalies - diagnosis
Coronary Vessel Anomalies - diagnostic imaging
Female
Heart Defects, Congenital - diagnosis
Heart Defects, Congenital - diagnostic imaging
Heart Ventricles - diagnostic imaging
Humans
Imaging
Incidental Findings
Medicine
Medicine & Public Health
Microbubbles
Original Paper
Phospholipids
Predictive Value of Tests
Radiology
Sulfur Hexafluoride
Tomography, X-Ray Computed
Ultrasonography
Vascular Fistula - congenital
Vascular Fistula - diagnosis
Vascular Fistula - diagnostic imaging
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Summary:Coronary artery fistulae, including generalized coronary arteriosystemic fistulae, are usually identified incidentally during invasive coronary angiographies. Generalized or multiple coronary arteriosystemic fistulae arise from all three major coronary arteries draining into the left ventricular chamber. In a patient with generalized coronary arteriosystemic fistulae, myocardial ischemia and diastolic volume overload of the left ventricle can be caused by a left-to-left shunt; however, the clinical and hemodynamic consequences are incompletely understood. We report the case of generalized coronary arteriosystemic fistulae in a 73-year-old female who presented with mild exertional dyspnea as an anginal equivalent. This case report represents the complementary, non-invasive role of transthoracic contrast echocardiography and multidetector computed tomography (MDCT) coronary angiography in the early recognition of generalized coronary arteriosystemic fistulae by demonstrating a plexus of multiple small vessels emptying exclusively into the left ventricle.
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-011-9866-6