A case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute myocardial infarction in a 27-year-old man.
- Author:
Yu Seoung SEO
1
;
Jae Wooing CHOI
;
Chang Sup SONG
;
Yong Bum CHO
;
Jin Su YANG
;
Jun Sup PARK
;
In Su JUNG
Author Information
1. Department of Internal Medicine, Nowon Eulji hospital, Seoul, Korea. cjw1108@eulji.or.kr
- Publication Type:Case Report
- Keywords:
Coronary fistula;
AMI;
Thallium-201 scan;
Embolization
- MeSH:
Adult*;
Arteries;
Chest Pain;
Constriction, Pathologic;
Coronary Vessels;
Dipyridamole;
Electrocardiography;
Emergency Service, Hospital;
Ergonovine;
Fistula*;
Follow-Up Studies;
Humans;
Myocardial Infarction*;
Perfusion;
Pulmonary Artery*
- From:Korean Journal of Medicine
2003;65(2):245-250
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.
