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Journal of the Korean Geriatrics Society 2003;7(3):243-251.
Published online September 30, 2003.
A Case of Ischemic Angina with Heart Failure due to Congenital Coronary Aterial Anomaly
Kwang Won Ryu, Sin Bae Joo, Seung Min Choi, Young Jin Joo, Young Jin Kim, Hong Sun Lee
노인환자에서 선천성 관상동맥 기형에 의해 발생한 허혈성 심장병에 병발한 심부전증 1예
Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Key Words: Coronary artery fistula, Left to left shunt, Coronary steal syndrome, Myocardial ischemia, Left ventricular end-diastolic volume overload
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