Document Detail


Heart failure with transient left bundle branch block in the setting of left coronary fistula.
MedLine Citation:
PMID:  21331342     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Coronary arterial fistulas are rare communications between vessels or chambers of the heart. Although cardiac symptoms associated with fistulas are well described, fistulas are seldom considered in the differential diagnosis of acute myocardial ischemia. We describe the case of a 64-year-old man who presented with left shoulder pain, signs of heart failure, and a new left bundle branch block (LBBB). Cardiac catheterization revealed a small left anterior descending (LAD)-to-pulmonary artery (PA) fistula. Diuresis led to subjective improvement of the patient's symptoms and within several days the LBBB resolved. We hypothesize that the coronary fistula in this patient contributed to transient ischemia of the LAD territory through a coronary steal mechanism. We elected to observe rather than repair the fistula, as his symptoms and ECG changes resolved with treatment of his heart failure.
Authors:
Stephen P Juraschek; Lara C Kovell; Ryan E Childers; Grant V Chow; Glenn A Hirsch
Publication Detail:
Type:  Journal Article     Date:  2011-02-07
Journal Detail:
Title:  Cardiology research and practice     Volume:  2011     ISSN:  2090-0597     ISO Abbreviation:  Cardiol Res Pract     Publication Date:  2011  
Date Detail:
Created Date:  2011-02-18     Completed Date:  2011-07-14     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  101516542     Medline TA:  Cardiol Res Pract     Country:  Egypt    
Other Details:
Languages:  eng     Pagination:  786287     Citation Subset:  -    
Affiliation:
Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD 21224, USA.
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