Korean Circ J.  2004 Mar;34(3):314-318. 10.4070/kcj.2004.34.3.314.

Acute Myocardial Infarction due to Coronary Arteriovenous Fistula in the Left Main and Anterior Descending Coronary Artery

• Lim JH
• Jeong MH
• Hong YJ
• Park HW
• Kim HG
• Park OY
• Kim JH
• Kim W
• Ahn YK
• Cho JG
• Park JC
• Kang JC

• KMID: 2227218
• DOI: http://doi.org/10.4070/kcj.2004.34.3.314

Abstract

A coronary arteriovenous fistula (CAVF) is an unusual anomaly in adults, and a CAVF arising from the left main and anterior descending arteries, presenting with acute myocardial infarction and cardiogenic shock, has not been reported. A 62 year-old male suffered from chest discomfort of 3-hour duration. His blood pressure at the emergency room was 70/40 mmHg, and an electrocardiogram showed marked ST segment depression in leads II, III and aVF, and from V3 to V6. The levels of creatinine kinase-MB and troponin I were 65 U/L and 4.36 ng/mL, respectively. A diagnostic coronary angiogram revealed no significant coronary stenosis, but large coronary arteriovenous fistulae originating from the left main and anterior descending coronary arteries to the main pulmonary artery. Surgical ligation for a CAVF was successfully performed, and a one-month follow-up coronary angiogram showed completely ligated fistulae.

Keyword

Coronary disease; Fistula; Myocardial infarction; Surgery

MeSH Terms

Adult
Arteries
Arteriovenous Fistula*
Blood Pressure
Coronary Disease
Coronary Stenosis
Coronary Vessels*
Creatinine
Depression
Electrocardiography
Emergency Service, Hospital
Fistula
Follow-Up Studies
Humans
Ligation
Male
Middle Aged
Myocardial Infarction*
Pulmonary Artery
Shock, Cardiogenic
Thorax
Troponin I
Creatinine
Troponin I