Key result
Selective coronary arteriography revealed coronary fistulous communications with the left ventricular chamber adjacent to a giant mural thrombus, with contrast media emptying directly into the chamber.
Case Report (n=1)
No
Coronary fistulous communications with the left ventricular chamber adjacent to a giant mural thrombus after MI can present with contrast emptying directly into the chamber, which should not be misinterpreted as a rare coronary artery-cardiac chamber shunt.
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May mimic coronary-chamber shunt on arteriography in post-MI mural thrombus; leaves open whether this represents underrecognized anatomy or distinct entity.
Selective coronary arteriography, performed in a 67-year-old man with post-infarction angina, demonstrated severe three vessel disease and coronary fistulous communications with the left ventricular chamber adjacent to a giant mural thrombus formed in the apical aneurysm. Most of the contrast media seemed to empty directly into the chamber without presenting hypervascular blushes of the thrombus itself. This was somewhat different from the observation previously reported in a case with coronary fistulae associated with a post infarction mural thrombus. It was stressed that one should not misinterpret this condition as a rare coronary artery-cardiac chamber shunt associating myocardial infarction.
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Nawa et al. (1994) conducted a case report in Coronary fistulous communications with left ventricular chamber and giant mural thrombus after myocardial infarction (n=1). Selective coronary arteriography was evaluated on Angiographic features. Selective coronary arteriography revealed coronary fistulous communications with the left ventricular chamber adjacent to a giant mural thrombus, with contrast media emptying directly into the chamber.
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