Title:Coronary Fistula Between Left Anterior Descending Artery (LAD) and Pulmonary Artery (PA) Leading to Sudden Cardiac Death: Case Report with Literature Review
VOLUME: 16 ISSUE: 2
Author(s):Ayman Battisha*, Bader Madoukh, Omar Sheikh, Ahmed Altibi, Shakil Sheikh and Mohammed Al-Sadawi
Affiliation:Department of Internal Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, MA 01003, Department of Internal Medicine, Overland Park Regional Medical Center-HCA Midwest Health, Overland Park, Kansas, KS, Department of Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 77030, Department of Internal Medicine, Henry Ford Allegiance Health, Jackson, MI, Department of Cardiology, State University of New York, Downstate Medical Center, Brooklyn, New York, NY 12222, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, NY 12222
Keywords:Coronary fistula, fistula between LAD and pulmonary artery, congenital coronary artery disease, angina, dyspnea,
heart failure.
Abstract:Coronary Artery Fistulas (CAF) are inappropriate connections between a coronary artery
and a major vessel or a cardiac chamber. These fistulas may or may not present with symptoms, but
they need to be detected as early as possible in order to decide the most appropriate treatment
methodology (i.e. surgery vs. conservative management). We report the case of a 67-year-old female
with no modifiable cardiovascular risk factors who had an unwitnessed sudden death at home
during her ongoing evaluation of a fistula detected incidentally between the Left Anterior Descending
Artery (LAD) and the Pulmonary Artery (PA). This case highlights that early diagnosis and
treatment of symptomatic CAF are crucial to minimize the risk of sudden cardiac death. Although
the symptomatic fistula of LAD to PA has been reported in the literature multiple times, it has been
rarely reported that this fistula can result in sudden cardiac death.
