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A Case of Giant Coronary Artery Fistula Diagnosed by Intravenous Contrast Echocardiography Shinichiro Fujimoto 1 , Kenzaburo Kobayashi 1 , Fumihiko Hara 1 , Miki Takata 1 , Shuichi Ishida 1 , Hiroshi Muto 1 , Junichi Yamazaki 1 1The First Department of Internal Medicine, Toho University School of Medicine Omori Hospital Keyword: 冠動脈痩 , 経静脈的コントラストエコー図 , 肥大型心筋症 , coronary artery fistula , intravenous contrast echocardiography , hypertrophic cardiomyopathy pp.1069-1073
Published Date 2002/10/15
DOI https://doi.org/10.11477/mf.1404902554
  • Abstract
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The patient was a 72-year-old male, under treatmentat another hospital for hypertrophic cardiomyopathy. He was referred to our clinic for detailed tests prior to an operation for cancer of the stomach. Transthoracic echocardiography revealed marked hypertrophy, dilata-tion and moniliform luminal structure of the proximal side of the coronary arteries, suggesting a giant-coro-nary aneurysm. As the configuration of the distal side was unclear, intravenous contrast echocardiography was conducted, which demonstrated coronary blood flow into the left ventricle at diastole. Consequently, a giant-coronary aneurysm and a coronary fistula were diagnosed. Coronary angiography showed marked dilatant and tortuous coronary arteries on both sides, through which blood flowed into the left ventricle. Although coronary artery fistula is generally asymptomatic, myocardial ischemia and heart failure may occur, depending on the site of the opening and the shunt volume. For this reason, it requires accurate diagnosis and follow-up. The use of contrast echocar-diography in the present case demonstrated a non-inva-sive diagnostic capability, which was as effective as coronary angiography.


Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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