Significance of Congenital Coronary Artery Fistulas

Congenital coronary artery fistulas (CAFs) are anomalous terminations of coronary arteries in cardiac chambers or great arteries created by bypassing the myocardial capillary bed. CAFs are the second most common coronary anomaly after coronary artery origin anomalies. CAFs are mostly asymptomatic. However, CAFs may cause myocardial ischemia, angina pectoris, congestive heart failure, arrhythmias and infective endocarditis.

Previously, we presented a case of multiple coronary-cameral fistulas causing stable angina pectoris . A 65-year-old male patient referred to our outpatient clinic withchest pain and exertional dyspnea. The patient was suffering from retrosternal exertional chest pain for six months which relieved with rest. Previous medical history revealed hypertension and diabetes mellitus. Electrocardiogram showed inferolateral T wave inversion (Figure A) and echocardiography revealed normal left ventricular systolic function without left ventricular hypertrophy or cardiomyopathy. Coronary angiography was performed with an early diagnosis of coronary artery disease. Read more..........