■冠状动脉瘘是一种罕见的诊断,这可能会在心脏成像中偶然发现。虽然大多数病例是无症状的,它们可能会因心肌缺血而变得复杂,心律失常,心力衰竭,感染性心内膜炎,很少有瘘破裂或血栓形成导致猝死。
■一位73岁的女性出现发烧,嗜睡,以及检查发现持续的心脏杂音.CT冠状动脉造影证实冠状动脉动脉瘘的存在,从右冠状窦出现动脉瘤RCA,在环绕心脏的曲折过程中,终止于右心房。虽然在血培养取样中发现了最初的链球菌菌血症,阀门上没有检测到明显的质量,Chamers,或者沿着瘘管的过程。随着时间的推移,她会出现心绞痛胸痛和心力衰竭症状,伴有右心室进行性扩张和功能性三尖瓣反流,继发于瘘管分流到右腔。然后进行手术干预并成功解决了这些并发症。
■本病例报告强调了先进的成像方式对准确诊断冠状动脉支架瘘的重要性。解决疾病的晚期表现和合作的必要性,管理复杂心脏异常的多学科方法。
UNASSIGNED: Coronary cameral fistula is a rare diagnosis, which may be picked up incidentally on cardiac imaging. While majority of cases is asymptomatic, they can be complicated by myocardial ischaemia, arrhythmias, heart failure, infective endocarditis, and rarely rupture or thrombosis of the fistula leading to sudden death.
UNASSIGNED: A 73-year-old female presents with fever, lethargy, and examination finding of a continuous cardiac murmur. CT coronary angiogram confirmed the presence of a coronary cameral fistula, with an aneurysmal RCA seen arising from the right coronary sinus, following an extensive tortuous course wrapping around the heart, and terminating at the right atrium. While there was initial streptococcus bacteraemia identified on blood culture sampling, no obvious masses were detected on the valves, chambers, or along the course of the fistula. Over time, she develops anginal chest pain and heart failure symptoms, with progressive dilatation of the right ventricle and functional tricuspid regurgitation secondary to shunting of the fistula into the right chambers. Surgical intervention was then pursued and successfully addressed these complications.
UNASSIGNED: This
case report highlights the importance of advanced imaging modalities for accurate diagnosis of coronary cameral fistulae, addressing late manifestations of the disease and the necessity for a collaborative, multidisciplinary approach in managing complex cardiac anomalies.