Korean J Med.  2003 Aug;65(2):245-250.

A case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute myocardial infarction in a 27-year-old man

• Seo YS
• Choi JW
• Song CS
• Cho YB
• Yang JS
• Park JS
• Jung IS

Abstract

We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.

Keyword

Coronary fistula; AMI; Thallium-201 scan; Embolization

MeSH Terms

Adult*
Arteries
Chest Pain
Constriction, Pathologic
Coronary Vessels
Dipyridamole
Electrocardiography
Emergency Service, Hospital
Ergonovine
Fistula*
Follow-Up Studies
Humans
Myocardial Infarction*
Perfusion
Pulmonary Artery*
Dipyridamole
Ergonovine