Korean Circ J.  2003 Apr;33(4):338-342. 10.4070/kcj.2003.33.4.338.

A Case of Multiple Coronary Artery-Left Ventricular Microfistulae Demonstrated by Transthoracic Doppler Echocardiography

• Choi SH
• Seo H
• Oh SJ
• Hong GR
• Kang SM
• Lee MH
• Rim SJ
• Jang Y
• Chung N
• Cho SY

• KMID: 2093871
• DOI: http://doi.org/10.4070/kcj.2003.33.4.338

Abstract

Of the congenital coronary artery fistulae, the multiple coronary artery microfistulae, arising from the left and right coronary artery emptying into the left ventricle, are very rare. Little is known about their anatomic and clinical features, especially in apical hypertrophic cardiomyopathy. The clinical findings are heterogeneous, but include, in most cases, a history of typical or atypical angina pectoris. A 67 year old woman was referred for evaluation of chest pain on exertion, and a shortness of breath. The electrocardiographic and echocardiographic findings were typical of apical hypertrophic cardiomyopathy. Coronary arteriography showed normal epicardial coronary arteries, but multiple coronary artery-left ventricular microfistulae arising from the left and right coronary arteries. Transthoracic Doppler echocardiography, using a high frequency transducer, with a low Nyquist limit, demonstrated multiple coronary artery-left ventricular microfistulae just beneath the apical impulse window.

Keyword

Hypertrophic cardiomyopathy; Echocardiography Doppler pulsed; Vascular fistula

MeSH Terms

Aged
Angina Pectoris
Angiography
Cardiomyopathy, Hypertrophic
Chest Pain
Coronary Vessels
Dyspnea
Echocardiography
Echocardiography, Doppler*
Electrocardiography
Female
Fistula
Heart Ventricles
Humans
Transducers
Vascular Fistula