Case Report
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World J Cardiol. Mar 26, 2014; 6(3): 112-114
Published online Mar 26, 2014. doi: 10.4330/wjc.v6.i3.112
Steal syndrome secondary to coronary artery fistulae associated with giant aneurysm
Anastasia Vlachadis Castles, Tamara Mogilevski, Muhammad Asrar ul Haq
Anastasia Vlachadis Castles, Tamara Mogilevski, Muhammad Asrar ul Haq, Department of Cardiology, The Northern Hospital, Epping, VIC 3076, Australia
Muhammad Asrar ul Haq, Department of Medicine, University of Melbourne, Parkville, VIC 3010, Australia
Author contributions: Each of the listed authors contributed to drafting and revision of this manuscript.
Correspondence to: Dr. Muhammad Asrar ul Haq, Department of Cardiology, The Northern Hospital, 185 Cooper Street, Epping, VIC 3076, Australia. muhammad.asrar@unimelb.edu.au
Telephone: +61-3840-58000 Fax: +61-3840-58524
Received: October 29, 2013
Revised: December 11, 2013
Accepted: January 17, 2014
Published online: March 26, 2014
Abstract

Giant coronary artery aneurysms and coronary artery fistulae are uncommon pathologies. We present the case of an elderly woman who was referred to cardiology for investigation of possible ischaemic heart disease prior to orthopaedic surgery. The patient had developed chest pain in the setting of a septic total knee replacement associated with changes on electrocardiography. Coronary angiography revealed multiple coronary arteriovenous fistulae associated with giant coronary artery aneurysm causing steal syndrome in the setting of haemodynamic stress.

Keywords: Coronary angiography, Coronary disease, Myocardial ischaemia, Coronary aneurysm, Vascular fistula, Chest pain

Core tip: This case report presents the angiographic findings of a rare occurrence of multiple coronary arteriovenous fistulae associated with giant coronary artery aneurysm and steal syndrome in the setting of haemodynamic stress.