Coronary Cameral Fistula

abnormal communications between the coronary arteries and cardiac chambers,

 

  • Cause
    • The most common cause of coronary cameral fistulae is abnormal embryogenesis.

      Other important causes include

      1. Trauma: stab injury or gunshot
      2. Invasive procedures: coronary angiography, pacemaker implantation, or endomyocardial biopsy
      3. Cardiac surgery: septal myomectomy
  • Result
    • Most fistulae terminate into the right ventricle or the right atrium. Rarely do they terminate into the left atrium or left ventricle
    • Clinical
      • Most coronary cameral fistulae are asymptomatic,
      • Some
        • steal phenomenon.
          • Ischemia of the myocardium distal to the coronary fistula
    • Laboratory tests:
      • cardiac enzymes may present elevated
  • Angiographic still (RAO cranial) demonstrating left anterior descending (LAD) draining to the right ventricle (RV)
    Kadhim H et al Multiple coronary cameral fistulae Br J Cardiol 2017;24:39–40
    Cardiac-gated computed tomography (CT) (saggital view) demonstrating the LAD and RCA fistulae to RV
    Kadhim H et al Multiple coronary cameral fistulae Br J Cardiol 2017;24:39–40

    Multi-planar reconstruction (MPR) detailing multiple fistulae. Both atria have been deleted for clearer demonstration
    Kadhim H et al Multiple coronary cameral fistulae Br J Cardiol 2017;24:39–40

Mansour MK Coronary Cameral Fistula