Coronary artery fistula diagnosed by transthoracic Doppler echocardiography

Chee TS, Tan PJ, Koh SK, Jayaram L
Correspondence: Dr Chee Tek Siong, tschee@singnet.com.sg

ABSTRACT
A 47-year-old Malay woman complained of an episode of shortness of breath after a shower. There was no previous complaint of shortness of breath or chest pain. Physical examination revealed a wide pulse pressure. Blood pressure was 160/66 mmHg, and heart rate was 77/minute and regular. What was initially thought to be a loud pansystolic murmur was heard over the precordium. Electrocardiography showed left ventricular hypertrophy with a volume overload pattern. Transthoracic Doppler echocardiography revealed a right coronary artery-right ventricular fistula, arising from the right coronary artery and draining into the right ventricular cavity.

Keywords: congenital cardiac anomalies, coronary artery fistula, coronary-ventricular fistula, Doppler echocardiography, transthoracic echocardiography
Singapore Med J 2007; 48(10): e262–e264