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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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| Published in: | European heart journal : case reports 2024-04, Vol.8 (4), p.ytae130 |
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| container_issue | 4 |
| container_start_page | ytae130 |
| container_title | European heart journal : case reports |
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| creator | Karthik, V Anosike, Chinedum Zivlas, Christos |
| description | 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. |
| doi_str_mv | 10.1093/ehjcr/ytae130 |
| format | article |
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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.</description><identifier>ISSN: 2514-2119</identifier><identifier>EISSN: 2514-2119</identifier><identifier>DOI: 10.1093/ehjcr/ytae130</identifier><identifier>PMID: 38567271</identifier><language>eng</language><publisher>UK: Oxford University Press</publisher><subject>Angiography ; Apixaban ; Cardiac patients ; Care and treatment ; Case Report ; Congenital heart disease ; CT imaging ; Fistula ; Genetic disorders ; Health aspects ; Ischemia ; Pulmonary embolism</subject><ispartof>European heart journal : case reports, 2024-04, Vol.8 (4), p.ytae130</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.</rights><rights>COPYRIGHT 2024 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-3425d50e60b3518fcea4da3acb6392787b06650064ccb96db12b3db0ef9a217d3</citedby><cites>FETCH-LOGICAL-c416t-3425d50e60b3518fcea4da3acb6392787b06650064ccb96db12b3db0ef9a217d3</cites><orcidid>0009-0005-7563-4977</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986395/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986395/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1598,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38567271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Olsen, Flemming Javier</contributor><contributor>Tan, Joon Heng</contributor><contributor>Lewis, Gavin</contributor><contributor>Spinthakis, Nikolaos</contributor><creatorcontrib>Karthik, V</creatorcontrib><creatorcontrib>Anosike, Chinedum</creatorcontrib><creatorcontrib>Zivlas, Christos</creatorcontrib><title>A case report of a young woman with pulmonary emboli and a right coronary artery-to-coronary sinus fistula</title><title>European heart journal : case reports</title><addtitle>Eur Heart J Case Rep</addtitle><description>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.</description><subject>Angiography</subject><subject>Apixaban</subject><subject>Cardiac patients</subject><subject>Care and treatment</subject><subject>Case Report</subject><subject>Congenital heart disease</subject><subject>CT imaging</subject><subject>Fistula</subject><subject>Genetic disorders</subject><subject>Health aspects</subject><subject>Ischemia</subject><subject>Pulmonary embolism</subject><issn>2514-2119</issn><issn>2514-2119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkc9LwzAUx4MoTuaOXiXgxUtn0rRpe5Ih_oKBFz2HJE23jDYpSarsvzfaOSYIkkDCe5_3fS_5AnCB0Ryjityo9Ua6m23gChN0BM7SHGdJinF1fHCfgJn3G4RQikhFC3IKJqTMaZEW-AxsFlByr6BTvXUB2gZyuLWDWcEP23EDP3RYw35oO2u420LVCdtqyE0dOadX6wCldWOOu6DcNgk22Ye8NoOHjfZhaPk5OGl469Vsd07B28P9691Tsnx5fL5bLBOZYRoSkqV5nSNFkSA5LhupeFZzwqWgpEqLshCI0hwhmkkpKloLnApSC6Saiqe4qMkU3I66_SA6VUtlguMt653u4kzMcs1-Z4xes5V9Z_FLy9gjjwpXo8KKt4pp09jIyU57yRZFlZU0bhyp-R9UXLXqtLRGNTrGfxUkY4F01nunmv1MGH01J-zbT7bzM_KXhw_Z0z_uReB6BOzQ_6P1CU9HrPQ</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Karthik, V</creator><creator>Anosike, Chinedum</creator><creator>Zivlas, Christos</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0009-0005-7563-4977</orcidid></search><sort><creationdate>20240401</creationdate><title>A case report of a young woman with pulmonary emboli and a right coronary artery-to-coronary sinus fistula</title><author>Karthik, V ; Anosike, Chinedum ; Zivlas, Christos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-3425d50e60b3518fcea4da3acb6392787b06650064ccb96db12b3db0ef9a217d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Angiography</topic><topic>Apixaban</topic><topic>Cardiac patients</topic><topic>Care and treatment</topic><topic>Case Report</topic><topic>Congenital heart disease</topic><topic>CT imaging</topic><topic>Fistula</topic><topic>Genetic disorders</topic><topic>Health aspects</topic><topic>Ischemia</topic><topic>Pulmonary embolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karthik, V</creatorcontrib><creatorcontrib>Anosike, Chinedum</creatorcontrib><creatorcontrib>Zivlas, Christos</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European heart journal : case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karthik, V</au><au>Anosike, Chinedum</au><au>Zivlas, Christos</au><au>Olsen, Flemming Javier</au><au>Tan, Joon Heng</au><au>Lewis, Gavin</au><au>Spinthakis, Nikolaos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A case report of a young woman with pulmonary emboli and a right coronary artery-to-coronary sinus fistula</atitle><jtitle>European heart journal : case reports</jtitle><addtitle>Eur Heart J Case Rep</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>8</volume><issue>4</issue><spage>ytae130</spage><pages>ytae130-</pages><issn>2514-2119</issn><eissn>2514-2119</eissn><abstract>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.</abstract><cop>UK</cop><pub>Oxford University Press</pub><pmid>38567271</pmid><doi>10.1093/ehjcr/ytae130</doi><orcidid>https://orcid.org/0009-0005-7563-4977</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | European heart journal : case reports, 2024-04, Vol.8 (4), p.ytae130 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10986395 |
| source | Oxford Journals Open Access Collection; PubMed Central |
| subjects | Angiography Apixaban Cardiac patients Care and treatment Case Report Congenital heart disease CT imaging Fistula Genetic disorders Health aspects Ischemia Pulmonary embolism |
| title | A case report of a young woman with pulmonary emboli and a right coronary artery-to-coronary sinus fistula |
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