Describes a rare presentation of angina pectoris caused by an anomalous origin of a coronary artery combined with a coronary artery fistula.
Anomalous coronary origins with fistulas warrant consideration in unexplained angina; extends differential diagnosis while leaving open optimal management strategies.
Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA), and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.
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Koneru et al. (2011) studied this question.
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