A case report of a young woman with pulmonary emboli and a right coronary artery-to-coronary sinus fistula

Abstract Background Coronary artery fistulae are rare cardiovascular anomalies that can present with atypical symptomatology and therefore pose diagnostic challenges, especially in young patients. Case summary A 34-year-old woman presented with left-sided pleuritic chest pain, haemoptysis, and flu-l...

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Bibliographic Details
Published in:European heart journal : case reports 2024-04, Vol.8 (4), p.ytae130
Main Authors: Karthik, V, Anosike, Chinedum, Zivlas, Christos
Format: Article
Language:English
Subjects:
Angiography
Apixaban
Cardiac patients
Care and treatment
Case Report
Congenital heart disease
CT imaging
Fistula
Genetic disorders
Health aspects
Ischemia
Pulmonary embolism
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Summary:Abstract Background Coronary artery fistulae are rare cardiovascular anomalies that can present with atypical symptomatology and therefore pose diagnostic challenges, especially in young patients. Case summary A 34-year-old woman presented with left-sided pleuritic chest pain, haemoptysis, and flu-like symptoms. Initial evaluation revealed multiple left-sided pulmonary emboli, and her transthoracic echocardiography showed turbulent flow in a dilated coronary sinus. A right coronary artery (RCA) to coronary sinus fistula was confirmed by computed tomography coronary angiogram. The patient was treated with lifelong anticoagulation, and a subsequent stress cardiac magnetic resonance imaging did not show inducible myocardial ischaemia. As such, the patient was managed conservatively. Discussion Utilization of multi-modality imaging is of utmost importance for diagnostic and therapeutic purposes in coronary artery fistulae. In this case report, our patient presented with unprovoked pulmonary emboli, which could be caused by the turbulent flow and stasis, due to the RCA-to-coronary sinus fistula.
ISSN:2514-2119
2514-2119
DOI:10.1093/ehjcr/ytae130