Key result
Point-of-care phonocardiography and multimodality imaging successfully characterize a rare right coronary artery fistula.
Why the study?
Coronary artery-to-superior vena cava fistulae are rare and can be misdiagnosed due to overlapping imaging features with other cardiac anomalies, necessitating clarification of the diagnostic role of phonocardiography.
Case Report (n=1)
Point-of-care phonocardiography and multimodality imaging are highly valuable for identifying and physiologically characterizing rare congenital anomalies like coronary artery-to-superior vena cava fistulae, preventing misdiagnosis and adverse cardiac remodeling.
May aid rare fistula characterization in select cases; leaves open routine phonocardiography adoption pending prospective validation.
Coronary arteriovenous fistulae (CAVFs) are rare, congenital low-resistance arteriovenous (AV) connections bypassing the intramyocardial circulation.1 CAVFs terminating in the superior vena cava (SVC) are the least common variant, representing <2% of cases.1 We describe a patient with a large CAVF to the SVC, discovered incidentally during atrial fibrillation evaluation and initially suspected to be ruptured sinus of Valsalva aneurysm (SOVA) on transthoracic echocardiography (TTE). Such large CAVFs create hemodynamically significant extracardiac shunts requiring percutaneous or surgical treatment.
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Basit et al. (2024) conducted a case report in Coronary artery-to-superior vena cava fistula (n=1). Point-of-care phonocardiography and multimodality imaging was evaluated. Point-of-care phonocardiography and multimodality imaging effectively characterized a rare, hemodynamically significant right coronary artery-to-superior vena cava fistula.
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