Congenital left ventricular septal aneurysm associated with coronary fistula / 대한내과학회지

ABSTRACT

Congenital left ventricular aneurysm is rare, poorly understood, and potentially lethal. Also, congenital coronary artery fistula is rare but hemodynamically, it induces myocardial ischemia due to coronary steal syndrome and diastolic volume overload from a left to left shunt. A 64-year-old women with abnormal ECG and mild exertional dyspnea was admitted to our hospital for further evaluation. Electrocardiography demonstrated Q waves, inverted T waves in the inferior leads and right bundle brach block. Transthoracic electrocardiography showed left ventricular septal aneurysm. Cardiac catheterization, a selective left coronary arteriogram revealed a fistula. The fistula originated from the proximal portion of the left anterior descending coronary artery and drained into the left ventricle. Magnetic resonance imaging demonstrated congenital defect muscular portion of interventricular septum. Thallium 201 heart spect showed regional perfusion defect along the inferior-lateral segment of the left ventricle. Then we report an congenital left ventricular septal aneurysm associated with coronary fistula.