Radiology Case Reports (Aug 2023)

Giant coronary artery fistula: A case report

  • Pham-Thi Thao Trang, MD,
  • Tran Chi Cuong, MD, PhD,
  • Nguyen Manh Cuong, MD,
  • Do Nguyen Tin, MD, PhD,
  • Nguyen Tran Tran, MD,
  • Le Minh Thang, MD,
  • Tran Hoa, MD, PhD,
  • Bui The Dung, MD, PhD,
  • Tran Ba Hieu, MD,
  • Nguyen Minh Duc, MD

Journal volume & issue
Vol. 18, no. 8
pp. 2621 – 2627

Abstract

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Coronary artery fistulas (CAFs) are abnormal connections of coronary arteries where venous circuits bypass the normal capillaries in the myocardium. CAFs are rare, and most patients are asymptomatic. However, CAFs are the most common coronary artery anomalies affecting coronary hemodynamics. While most CAFs are asymptomatic in young patients, symptoms and complications become more frequent with increasing age. CAFs are characterized by variable clinical manifestations based on their size, origin, and drainage site. We describe a 35-year-old woman presenting with the shortness of breath after walking. Despite attempting medical treatment, the patient continued to experience dyspnea, fatigue, fainting the and chest pain episodes. After admission, cardiac imaging was immediately performed and recorded symptomatic CAFs. Percutaneous transcatheter closure treatment was indicated. The patient was discharged with clinical recovery. The treatment of symptomatic CAFs often requires the clear cardiac imaging and endovascular approach to achieve the best clinical results.

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