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Spontaneous partial regression of coronary artery fistula following optimal medical therapy in a patient who had combined significant coronary artery spasm.

Lee S, Rha SW, Kook H, Kim DH, Oh SK, Cho DH, Kim W, Oh DJ - Korean Circ J (2013)

Bottom Line: Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies.Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants.We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.

ABSTRACT
Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies. Some patients with CAF may suffer from ischemic chest pain that originates from combined significant coronary artery spasm (CAS). Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants. We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test. Spontaneous regression of one of the fistulas was observed at 2-year angiography follow-up.

No MeSH data available.


Related in: MedlinePlus

Follow-up coronary angiography at two years. A and B: follow-up left coronary angiogram shows no remarkable change in both fistulas. C: previous right coronary angiogram. D: follow-up right coronary angiogram showing that the previous fistula from the right coronary artery has spontaneously regressed.
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Figure 4: Follow-up coronary angiography at two years. A and B: follow-up left coronary angiogram shows no remarkable change in both fistulas. C: previous right coronary angiogram. D: follow-up right coronary angiogram showing that the previous fistula from the right coronary artery has spontaneously regressed.

Mentions: Two years later, the patient visited the emergency room with ischemic chest pain at rest and follow-up coronary angiography was performed for definite evaluation. Coronary angiography showed no significant interval change as compared with the previous results especially in the AVF from LM to PA and that from LAD to PA. However, the main AVF from the proximal RCA to PA had spontaneously regressed (Fig. 4). After careful history taking, we ascertained that the patient had not taken antianginal medicine several days prior to visiting the emergency room. We accordingly restarted antianginal treatment, and her symptoms were improved and stabilized.


Spontaneous partial regression of coronary artery fistula following optimal medical therapy in a patient who had combined significant coronary artery spasm.

Lee S, Rha SW, Kook H, Kim DH, Oh SK, Cho DH, Kim W, Oh DJ - Korean Circ J (2013)

Follow-up coronary angiography at two years. A and B: follow-up left coronary angiogram shows no remarkable change in both fistulas. C: previous right coronary angiogram. D: follow-up right coronary angiogram showing that the previous fistula from the right coronary artery has spontaneously regressed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3675312&req=5

Figure 4: Follow-up coronary angiography at two years. A and B: follow-up left coronary angiogram shows no remarkable change in both fistulas. C: previous right coronary angiogram. D: follow-up right coronary angiogram showing that the previous fistula from the right coronary artery has spontaneously regressed.
Mentions: Two years later, the patient visited the emergency room with ischemic chest pain at rest and follow-up coronary angiography was performed for definite evaluation. Coronary angiography showed no significant interval change as compared with the previous results especially in the AVF from LM to PA and that from LAD to PA. However, the main AVF from the proximal RCA to PA had spontaneously regressed (Fig. 4). After careful history taking, we ascertained that the patient had not taken antianginal medicine several days prior to visiting the emergency room. We accordingly restarted antianginal treatment, and her symptoms were improved and stabilized.

Bottom Line: Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies.Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants.We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.

ABSTRACT
Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies. Some patients with CAF may suffer from ischemic chest pain that originates from combined significant coronary artery spasm (CAS). Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants. We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test. Spontaneous regression of one of the fistulas was observed at 2-year angiography follow-up.

No MeSH data available.


Related in: MedlinePlus