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Research Article | Volume 3 Issue:1 (, 2013) | Pages 21 - 30
Multiple Coronary–Cameral Fistulae in the Left Anterior Descending Coronary Artery Causing Angina Pectoris: A Clinical Case and the State of the Art
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Open Access
Published
March 23, 2013
Abstract

A 82-year-old man with hypercholesterolemia, hypertension and glucidic intolerance, presented with angina pectoris upon exertion. The vital signs were normal. Echocardiography showed normal left ventricular (LV) ejection fraction, non-critical aortic valvular stenosis and LV diastolic dysfunction. Rest and stress myocardial echocardiography showed a reversible abnormal septal-wall motion. Therefore, an initial diagnosis of possible coronary artery disease was made. Coronary arteriography showed no atherosclerotic lesions in the 3 major coronary arteries; however, in the anterior descending artery a communication with the right ventricle (RV) cavity through five small, diffuse fistulae was detected (Figure 1 and 2), resulting in complete RV contrast opacification. The patient was stabilised on medical therapy because he refused any further invasive therapy.

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