Author + information
- Received June 20, 2013
- Accepted July 9, 2013
- Published online February 18, 2014.
- Wojciech Braksator, MD, PhD∗,
- Wojciech Król, MD, PhD∗,
- Karol Wrzosek, MD, PhD∗,
- Jacek Sawicki, MD, PhD∗,
- Mateusz Śpiewak, MD, PhD†,
- Cezary Kępka, MD, PhD‡,
- Mirosław Dłużniewski, MD, PhD∗ and
- Piotr Hoffman, MD, PhD§
- ∗Department of Cardiology, Hypertension and Internal Medicine, 2nd Medical Faculty, Medical University of Warsaw, Warsaw, Poland
- †Department of Coronary Artery Disease and Structural Heart Diseases, Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland
- ‡Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland
- §Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland
A 63-year-old woman with no history of cardiovascular disorders was investigated because of a loud systolic murmur. Echocardiography demonstrated several circular echoes in the region of the coronary sinus (CS) (A, Online Videos 1 and 2) and in the right ventricular free wall. A turbulent (maximal velocity 3 to 4 m/s) inflow into the severely dilated proximal right coronary artery (RCA) (marked with ∗) was found (B, Online Videos 3 and 4). The coronarography confirmed the presence of an aneurysmatic (∼15 mm) RCA (C). Angiography failed to show the location of the shunt. Computed tomography angiogram (dual-source 128-slice scanner) revealed a large, tortuous, 14 mm in diameter RCA with fistula (marked with #) to extremely dilated (60 mm) coronary sinus (D, Online Videos 5 and 6). In addition, cardiac magnetic resonance showed turbulent flow into the right atrium (RA) from the coronary sinus (E, Online Video 7). There was no myocardial perfusion impairment. The patient was managed with clinical observation only and remained asymptomatic for 12 months. LV = left ventricle.
- Received June 20, 2013.
- Accepted July 9, 2013.
- American College of Cardiology Foundation