Yonsei Med J.  2003 Aug;44(4):710-714. 10.3349/ymj.2003.44.4.710.

Multiple Coronary Artery-Left Ventricular Microfistulae in a Patient with Apical Hypertrophic Cardiomyopathy: A Demonstration by Transthoracic Color Doppler Echocardiography

• Hong GR
• Choi SH
• Kang SM
• Lee MH
• Rim SJ
• Jang YS
• Chung NS

• KMID: 720913
• DOI: http://doi.org/10.3349/ymj.2003.44.4.710

Abstract

Among the congenital coronary artery fistulae, multiple coronary artery microfistulae arising from the left and right coronary artery and emptying into the left ventricle are very rare and little is known of their anatomic and clinical features, especially in apical hypertrophic cardiomyopathy. A 67-year- old woman was referred for the evaluation of chest pain at exertion, and shortness of breath. 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 color 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

Apical hypertrophic cardiomyopathy; transthoracic Doppler echocardiography; coronary artery-left ventricular microfistulae

MeSH Terms

Aged
Cardiomyopathy, Hypertrophic/*complications/diagnosis
Coronary Angiography
Coronary Vessel Anomalies/*complications/diagnosis/*ultrasonography
Echocardiography
Electrocardiography
Female
Heart Defects, Congenital/*complications/diagnosis/*ultrasonography
Heart Ventricles
Human
Hypertrophy, Left Ventricular/complications/diagnosis