Multiple Coronary–Cameral Fistulae in the Left Anterior Descending Coronary Artery Causing Angina Pectoris: A Clinical Case and the State of the Art

CASE REPORT, February 2014, VOL III ISSUE I, ISSN 2042-4884
10.5083/ejcm.20424884.111 , Cite or Link Using DOI
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Musuraca G, Agostoni P, Albiero R, Boldi E, Terraneo C, Angheben C


A 82-year-old man with hypercholesterolemia, hypertension and glucidic intolerance, presented with angina pectoris upon exertion. The vital signs were normal.

Echocardiography showed normal left ventricular (LV) ejection fraction, non-critical aortic valvular stenosis and LV diastolic dysfunction. Rest and stress myocardial echocardiography showed a reversible abnormal septal-wall motion.

Therefore, an initial diagnosis of possible coronary artery disease was made. Coronary arteriography showed no atherosclerotic lesions in the 3 major coronary arteries; however, in the anterior descending artery a communication with the right ventricle (RV) cavity through five small, diffuse fistulae was detected, resulting in complete RV contrast opacification.

The patient was stabilised on medical therapy because he refused any further invasive therapy.