ABSTRACT
We present the case of rare coronary circulation anomaly discovered during the routine coronary angiography that was associated with unusual "burning" sensation reported by the patient.
Subject(s)
Coronary Vessel Anomalies/diagnostic imaging , Heart Ventricles/abnormalities , Heart Ventricles/diagnostic imaging , Paresthesia/etiology , Vascular Fistula/congenital , Vascular Fistula/diagnostic imaging , Aged , Contrast Media/adverse effects , Coronary Angiography , Coronary Vessel Anomalies/complications , Female , Humans , Iohexol/adverse effects , Iohexol/analogs & derivatives , Tongue , Vascular Fistula/complicationsABSTRACT
To evaluate the effects of low altitude on exercise performance and myocardial ischemia, 12 patients with coronary artery disease and 6 normal controls underwent ergometric and exercise echocardiography in Haifa, 130 m above sea level, and at the Dead Sea, 402 m below sea level. At the Dead Sea, exercise duration increased by 15% (p <0.05) in the patient and control groups and wall motion score index was improved in patients at rest and after exercise, indicating that descent to the Dead Sea in patients with coronary disease is safe, improves exercise performance, and decreases ischemia.
Subject(s)
Altitude , Coronary Disease/physiopathology , Exercise Tolerance , Hemodynamics , Aged , Atmospheric Pressure , Case-Control Studies , Coronary Disease/rehabilitation , Ergometry , Female , Humans , Israel , Male , Middle Aged , Myocardial ContractionABSTRACT
A 62-year-old man was admitted to the coronary care unit due to anginal pain and palpitations--coronary angiography revealed three-vessel coronary artery disease. The unexpected finding was the presence of coronary to pulmonary artery fistulae bilaterally, from both the proximal RCA and the proximal LAD. Right heart catheterization revealed normal right ventricular and pulmonary artery pressure and absence of hemodynamically significant left to right shunt. The patient underwent a triple coronary bypass including the closure of bilateral fistulae, which were draining into the left sinus of the pulmonary valve. One month after the operation he was in good health and had no complaints. Bilateral coronary artery fistulae is a rare anomaly diagnosed in 0.002-0.0013% of adult coronary angiograms. (Int J Cardiovasc Intervent 1999; 2: 249-251).
