RESUMO
Coronary-cameral fistulas are abnormal connections between coronary arteries and any of the heart chambers, It may be acquired or congenital (whether isolated or along with congenital heart diseases); It is usually asymptomatic in younger patients; but with increasing age, symptoms begin to appear, and the incidence of complication rises. Coronary angiography is the gold standard in diagnosis but echography and cardiac magnetic resonance imaging may be also useful. It can be treated medically with ß-blockers or calcium channel blockers, but large fistulas with hemodynamic significant shunts should be closed by transcatheter or surgical means. We present a 57-year-old patient with a history of chest trauma, that present fistulas connecting the 3 coronary arteries to the left ventricle chamber complicated by myocardial ischemia causing stable angina.
RESUMO
Coronary artery embolism is an uncommon cause of myocardial infarction (MI). Among several etiologies of coronary embolism, we mention a very rare cause which is the paradoxical embolism via patent foramen ovale (PFO). It interests generally youngest people without cardiac risk factors. We report three cases who presented ST-elevation MI (STEMI) due to paradoxical embolism with high risk PFO that can justify embolic infarction. The aim of this article is to define the high risk PFO, to establish causal link between PFO and embolic events and to guide therapeutic management.