Ayman Battisha*, Bader Madoukh, Omar Sheikh, Ahmed Altibi, Shakil Sheikh and Mohammed Al-Sadawi Pages 98 - 102 ( 5 )
Coronary Artery Fistulas (CAF) are inappropriate connections between a coronary artery and a major vessel or a cardiac chamber. These fistulas may or may not present with symptoms, but they need to be detected as early as possible in order to decide the most appropriate treatment methodology (i.e. surgery vs. conservative management). We report the case of a 67-year-old female with no modifiable cardiovascular risk factors who had an unwitnessed sudden death at home during her ongoing evaluation of a fistula detected incidentally between the Left Anterior Descending Artery (LAD) and the Pulmonary Artery (PA). This case highlights that early diagnosis and treatment of symptomatic CAF are crucial to minimize the risk of sudden cardiac death. Although the symptomatic fistula of LAD to PA has been reported in the literature multiple times, it has been rarely reported that this fistula can result in sudden cardiac death.
Coronary fistula, fistula between LAD and pulmonary artery, congenital coronary artery disease, angina, dyspnea, heart failure.
Department of Internal Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, MA 01003, Department of Internal Medicine, Overland Park Regional Medical Center-HCA Midwest Health, Overland Park, Kansas, KS, Department of Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 77030, Department of Internal Medicine, Henry Ford Allegiance Health, Jackson, MI, Department of Cardiology, State University of New York, Downstate Medical Center, Brooklyn, New York, NY 12222, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, NY 12222