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. 2012 Oct;42(10):714-7.
doi: 10.4070/kcj.2012.42.10.714. Epub 2012 Oct 31.

Severe form of persistent thebesian veins presenting as ischemic heart disease

Younghee Jung  1 , Hyun-Jin Kim, Chang-Hwan Yoon
Affiliations

Severe form of persistent thebesian veins presenting as ischemic heart disease

Younghee Jung et al. Korean Circ J. 2012 Oct.

Abstract

Coronary artery fistula is a rare congenital anomaly. Most patients with this anomaly are asymptomatic, but some may develop heart failure, myocardial ischemia or arrhythmias. We report a case of a patient who presented with myocardial ischemia secondary to persistent Thebesian veins. Coronary angiography demonstrated a marked capillary blush draining into the left ventricular cavity through multiple microfistulae from the left anterior descending artery, left circumflex artery and right coronary artery. The patient was discharged without chest pain and was medically maintained with a beta-blocker and angiotensin converting enzyme inhibitor.

Keywords: Arteriovenous fistula; Coronary angiography; Coronary vessel anomalies; Myocardial ischemia.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Twelve-lead ECG showing sinus rhythm with T-wave inversion in V 2-4 2 hours after admission (B) compared to initial ECG (A). ECG: electrocardiography.
Fig. 2
Fig. 2
Coronary angiogram showing right coronary artery (A) and left main coronary artery (B). Arrows indicate multiple arteriosinousoidal fistulae filling with contrast agent on injection, visualizing the endocardial border (A and B).
See this image and copyright information in PMC

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