A young female with an unusual cause of dyspnea
- 作者：Elie Zoghbi ; Fadi Seif ; Mounir Obeid ; Gilbert Abou Nader ; Jaber Sawaya
- 关键词：Dyspnea ; Continuous heart murmur ; Coronary artery ; Fistula
- 刊名：International Journal of Cardiology
- 出版年：2007
- 期刊代码：128_01675273
- 类别：med
- 出版时间：30 November 2007
- 卷：122
- 期：3
- 页码：e21-e22
- 文件大小：298 K
摘要
Within the context of coronary artery anomalies, coronary fistulas are classified by termination. A coronary artery fistula (CAF) involves a sizable communication between a coronary artery and a heart chamber (coronary–cameral fistula) or a segment of the systemic or pulmonary system (coronary artery arteriovenous fistula). These are often due to deviations from normal embryological development. CAF may be present in patients at any age, but is usually suspected in early childhood and accounts for 0.08–0.4%of congenital cardiac anomalies. They may also be acquired by trauma or from invasive cardiac procedures. The majority of CAF arises from the right coronary artery (55%) and the left anterior descending coronary artery, with the circumflex rarely involved. The outcome of these connections depends upon the termination site. The pathophysiology of these lesions is identical. Coronary artery anomalies are difficult to detect clinically. Most are benign but some may produce symptoms that can be life threatening.
We present a female with an unusual cause of dyspnea found to have a continuous heart murmur, cardiac catheterization showed an evidence of a long tract arising from the origin of the right coronary artery with flow directed towards the right atrium and the right atrial appendage.