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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Intermittent appearance of right coronary fistula and collateral circulation: A case report
Wen-Jie Long, Xi Huang, Yuan-Hong Lu, Hao-Ming Huang, Guo-Wei Li, Xia Wang, Zhi-Ling He
Wen-Jie Long, Xi Huang, Department of Geriatrics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Yuan-Hong Lu, The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Hao-Ming Huang, Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Guo-Wei Li, Department of Emergency, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Xia Wang, Department of Cardiovascular, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Zhi-Ling He, Department of Cardiovascular, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Author contributions: Long WJ and Huang X contributed equally and wrote the main manuscript; Lu YH and Huang HM were responsible for figure preparation; Wang X, He ZL, and Li GW were responsible for patient management; He ZL designed the research study.
Supported by Scientific Research Project of Guangdong Provincial Bureau of Traditional Chinese Medicine, NO. 20212061; and Guangdong Province Basic and Applied Research Fund Project, NO. 2020A1515110520.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Zhi-Ling He, PhD, Doctor, Department of Cardiovascular, Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu district, Guangzhou 510006, Guangdong Province, China. hezhiingl2000@163.com
Received: March 29, 2021
Peer-review started: March 29, 2021
First decision: April 28, 2021
Revised: May 10, 2021
Accepted: August 19, 2021
Article in press: August 19, 2021
Published online: October 6, 2021
BACKGROUND
Congenital coronary artery fistula can lead to symptoms of chest tightness, chest pain, or exertional dyspnea, which is a congenital vascular malformation that should not be ignored. Patients who have such malformations are frequently observed with different concurrent abnormal anatomic structures. Collateral circulation may have a positive effect on improving the patients' symptoms.
CASE SUMMARY
A 53-year-old female experienced episodic chest discomfort for the past month with symptoms manifesting when she was agitated or overexerted. After a positive treadmill test, the patient underwent coronary angiography. “Ghostlike” intermittent appearance of coronary ventricular fistula and collateral branching were observed. The patient was diagnosed with a right coronary ventricular fistula and collateral circulation.
CONCLUSION
This case shows the likelihood of collateral circulation in patients with coronary artery fistula. This may provide medical staff with novel solutions to treat insufficiency of myocardial blood supply induced by cardiovascular malformations.
Core Tip: Congenital coronary artery fistula is a congenital vascular malformation that should not be overlooked. It can lead to symptoms of myocardial ischemia. In the report, we describe a patient who had episodic chest discomfort. Coronary angiography demonstrated a “ghostlike” intermittent appearance of coronary ventricular fistula and collateral branching. The patient was diagnosed with a right coronary ventricular fistula and collateral circulation. This case shows the likelihood of collateral circulation in patients with coronary artery fistula and may provide us with novel strategies for solving insufficiency of myocardial blood supply induced by cardiovascular malformations.
