Title: Untypical course of ischemic heart disease in a woman with isolated coronary artery fistula – a case report
- Dariusz A. Kosior, Krzysztof J. Filipiak, Krzysztof Putkiewicz, Janusz Kochanowski, Artur Oręziak, Grzegorz Opolski
- Case Reports
- Polish Journal of Cardiology
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- Final page:
- coronary artery fistula, congenital coronary artery anomaly, ischemic heart disease
A 52-year-old woman, office worker, was admitted to the hospital for evaluation of the recurrent untypical chest pain. Symptoms usually occurred at rest and lasted for several minutes with spontaneous recovery. The patient had suffered from such symptoms for three years with increased intensity within the last two weeks. Additionally, for the last 12 months the patient experienced paroxysmal heart palpitations for a lasting few minutes and episodes of fainting without total unconsciousness. 24-hour Holter ECG monitoring did not demonstrate any rhythm and/or conduction disturbances. Electrocardiographic stress test performed during hospitalisation revealed myocardial ischemia with ST segment depression in lead II, III, aVF, V5-V6. Coronary angiography showed the right coronary artery – left ventricle fistula without other coronary lesions. The patient refused surgical correction of the coronary vessel anomaly. After modification of pharmacological treatment, which turned out to be successful in short-term observation, the patient was discharged from the hospital.