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Case Reports
. 2024 Jun 3;16(6):e61604.
doi: 10.7759/cureus.61604. eCollection 2024 Jun.

Coronary Cameral Fistula: A Rare Case Presenting With Non-ST-Segment Elevation Myocardial Infarction and Pulmonary Arterial Hypertension

Jimmy Saleh  1 , Mersal Samimi  1 , Asseel Al-Bayati  2 , Henning Rasmussen  2 , Richard Kiel  2
Affiliations
Case Reports

Coronary Cameral Fistula: A Rare Case Presenting With Non-ST-Segment Elevation Myocardial Infarction and Pulmonary Arterial Hypertension

Jimmy Saleh et al. Cureus. .

Abstract

Coronary cameral fistulas (CCFs) are uncommon congenital or acquired anomalies characterized by abnormal connections between a coronary artery and a cardiac chamber. While often asymptomatic and incidentally detected, symptomatic presentations are rare, and symptoms may vary depending on the size and location of the fistula. We present the case of a 67-year-old female with complaints of intermittent typical cardiac chest pain and exertional dyspnea. Further evaluation revealed a CCF originating from the left anterior descending coronary artery and the left ventricle. Additionally, the patient was found to have pulmonary hypertension on right heart catheterization. This case highlights the importance of considering CCF in the differential diagnosis of chest pain, particularly in the presence of atypical symptoms and associated pulmonary hypertension (WHO Group 4). Further research is warranted to elucidate the optimal management strategies for symptomatic CCF, especially in cases complicated by pulmonary hypertension.

Keywords: cardiac chest pain; congenital cardiac anomaly; coronary cameral fistula; non-st segment elevation myocardial infarction (nstemi); – pulmonary hypertension.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Prior electrocardiogram depicting a normal sinus rhythm pattern without T-wave inversions in V1-V5
Figure 2
Figure 2. Electrocardiogram taken at the time of presentation with chest pain demonstrating T-wave inversions in leads V1-V5
Figure 3
Figure 3. Angiographic photo displaying contrast injected into the RCA with evidence of contrast entering the LV
LV, left ventricle; RCA, right coronary artery
Figure 4
Figure 4. Angiographic photo showing a CCF originating from the LAD artery and terminating into the LV
CCF, coronary cameral fistula; LAD, left anterior descending; LV, left ventricle
See this image and copyright information in PMC

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