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Case Reports
. 2015 May-Jun;35(3):257-9.
doi: 10.5144/0256-4947.2015.257.

A rare cause of exercise induced ventricular tachycardia

Aakash Aggarwal  1 , Sumant Arora, Pahul Singh, Amitpal Nat
Affiliations
Case Reports

A rare cause of exercise induced ventricular tachycardia

Aakash Aggarwal et al. Ann Saudi Med. 2015 May-Jun.

Abstract

Coronary fistulas are anomalous shunts from a coronary artery to a cardiac chamber or great vessel, bypassing the myocardial circulation. A 42-year-old Asian man with no significant history of cardiac disease presented with exertional chest discomfort in the form of chest tightness over the precordial area. The patient had no cardiac risk factors, but given the duration and persistence of symptoms, we did a stress echocardiogram. The exercise led to a 'coronary artery steal phenomenon' caused by the coronary fistula, which diverted the blood from the left anterior descending artery to the pulmonary artery thereby producing the ischemic symptoms and ventricular tachycardia. Transcatheter coil embolization was unsuccessful, but the fistula was eventually closed surgically. A repeat stress echocardiogram before discharge was completely normal. We emphasize the need to individualize treatment, taking into consideration all factors in a particular patient.

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Figures

Figure 1
Figure 1
Cardiac catheterisation.
Figure 2
Figure 2
A) Magnified view, arrows points to the fistula. B) CTA coronary arteries.
See this image and copyright information in PMC

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