An unusual cause of atrial fibrillation in a young active duty soldier

Coronary artery fistula (CAF) is an abnormality in which the coronary artery has an anomalous connection with a venous structure such as the coronary sinus or atrium. CAF is usually congenital, but may be acquired. The prevalence in the general population is low with many asymptomatic and discovered...

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Main Authors: Rafik BenAbda, DO, Anne Gunn, DO, Eric Roberge, MD, Ting-Wei Yang, MD
Format: Article
Language:English
Published: Elsevier 2017-06-01
Series:Radiology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043316303454
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author Rafik BenAbda, DO
Anne Gunn, DO
Eric Roberge, MD
Ting-Wei Yang, MD
author_facet Rafik BenAbda, DO
Anne Gunn, DO
Eric Roberge, MD
Ting-Wei Yang, MD
author_sort Rafik BenAbda, DO
collection DOAJ
description Coronary artery fistula (CAF) is an abnormality in which the coronary artery has an anomalous connection with a venous structure such as the coronary sinus or atrium. CAF is usually congenital, but may be acquired. The prevalence in the general population is low with many asymptomatic and discovered incidentally. When symptomatic, CAF may present with dyspnea, decreasing functional capacity, and/or arrhythmia. We report a case of a young otherwise healthy active duty male with progressive symptoms of dizziness and exertional fatigue with paroxysmal atrial fibrillation. An electrically negative, but symptomatically positive stress test led to further workup with coronary computed tomography angiogram, which unexpectedly revealed large coronary fistulas between the aneurysmal right coronary artery and coronary sinus and the dilated left circumflex artery with probable collateralization to the coronary sinus. Cardiac magnetic resonance imaging and cardiac catheterization supported these findings and demonstrated no evidence of significant shunting.
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spelling doaj.art-e676cd17bc074da99d13aa8cb9f2fb2c2022-12-21T22:22:04ZengElsevierRadiology Case Reports1930-04332017-06-0112223323510.1016/j.radcr.2017.01.012An unusual cause of atrial fibrillation in a young active duty soldierRafik BenAbda, DO0Anne Gunn, DO1Eric Roberge, MD2Ting-Wei Yang, MD3Department of Radiology, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, USADepartment of Radiology, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, USADepartment of Radiology, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, USANaval Hospital Bremerton, Department of Cardiology, Bremerton, WA, USACoronary artery fistula (CAF) is an abnormality in which the coronary artery has an anomalous connection with a venous structure such as the coronary sinus or atrium. CAF is usually congenital, but may be acquired. The prevalence in the general population is low with many asymptomatic and discovered incidentally. When symptomatic, CAF may present with dyspnea, decreasing functional capacity, and/or arrhythmia. We report a case of a young otherwise healthy active duty male with progressive symptoms of dizziness and exertional fatigue with paroxysmal atrial fibrillation. An electrically negative, but symptomatically positive stress test led to further workup with coronary computed tomography angiogram, which unexpectedly revealed large coronary fistulas between the aneurysmal right coronary artery and coronary sinus and the dilated left circumflex artery with probable collateralization to the coronary sinus. Cardiac magnetic resonance imaging and cardiac catheterization supported these findings and demonstrated no evidence of significant shunting.http://www.sciencedirect.com/science/article/pii/S1930043316303454CoronaryArteryFistula
spellingShingle Rafik BenAbda, DO
Anne Gunn, DO
Eric Roberge, MD
Ting-Wei Yang, MD
An unusual cause of atrial fibrillation in a young active duty soldier
Radiology Case Reports
Coronary
Artery
Fistula
title An unusual cause of atrial fibrillation in a young active duty soldier
title_full An unusual cause of atrial fibrillation in a young active duty soldier
title_fullStr An unusual cause of atrial fibrillation in a young active duty soldier
title_full_unstemmed An unusual cause of atrial fibrillation in a young active duty soldier
title_short An unusual cause of atrial fibrillation in a young active duty soldier
title_sort unusual cause of atrial fibrillation in a young active duty soldier
topic Coronary
Artery
Fistula
url http://www.sciencedirect.com/science/article/pii/S1930043316303454
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