The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Acquired Coronary-Cameral Fistulae

후천성 다발성 관상동맥-심방실누공 1예

  • Ahn, Jem Ma (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital) ;
  • Lee, Jae Min (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital) ;
  • Hwang, Young Jae (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital) ;
  • Seo, Young Ho (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital) ;
  • Kim, Yong Hyun (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital) ;
  • Ahn, Jeong Cheon (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital) ;
  • Song, Woo Hyuk (Division of Cardiology, Department of Internal Medicine, Korea University Asan Hospital)
  • 안젬마 (고려대학교 의과대학 안산병원 순환기내과) ;
  • 이재민 (고려대학교 의과대학 안산병원 순환기내과) ;
  • 황영재 (고려대학교 의과대학 안산병원 순환기내과) ;
  • 서영호 (고려대학교 의과대학 안산병원 순환기내과) ;
  • 김용현 (고려대학교 의과대학 안산병원 순환기내과) ;
  • 안정천 (고려대학교 의과대학 안산병원 순환기내과) ;
  • 송우혁 (고려대학교 의과대학 안산병원 순환기내과)
  • Published : 2013.01.01
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Abstract

We report a rare case of acquired multiple coronary-cameral fistulae. A 46-year-old man presented to the cardiology department clinic complaining of recently aggravated exertional chest pain. He had been treated 10 years ago for an acute ST segment elevation myocardial infarction (STEMI) with percutaneous coronary intervention (PCI). During revascularization, diffuse multiple fistulae from the left anterior descending (LAD) artery to the left ventricle (LV) had been observed. The current chest pain was evaluated by elective coronary angiography but no significant stenosis was observed. However, newly developed diffuse fistulae from the distal right coronary artery (RCA) to LV were found during angiography, as well as LAD-LV coronary fistulae. Multiple coronary- cameral fistulae were thought to be causing chest pain. A beta-blocker was prescribed and, after 3 months of follow-up, exertional chest pain had subsided without further complication.

본 증례는 급성 심근경색으로 시행했던 응급 재관류 시술에서 좌전 하행지 관상동맥-좌심실 누공(LAD-LV fistulae)을 발견했고, 10년 후 비전형적인 흉통이 재발하여 시행한 관상동맥 조영술에서 이전 누공(LAD-LV fistulae) 외에 우관상동맥-좌심실 누공(RCA-LV fistulae)을 새롭게 관찰한 예이다. 대다수의 관상동맥 누공은 선천적으로 발생하고 단일혈관에 서 기시하며 대개 우심방 또는 우심실로 유입되나, 본 증례의 관상동맥 누공은 후천적으로 발생하였고 다혈관에서 기시하였으며 모두 좌심실로 유입되었다. 이는 매우 희귀한 경우로 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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