Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Huda Elshershari and Mark A Hubbard
Deaconess Hospital, USA
Posters & Accepted Abstracts: J Clin Exp Cardiolog
A 43-year-old female presented to our institution with recurrent episodes of left upper and lower extremity numbness associated with palpitation and shortness of breath. Her vital signs were stable and physical examination was remarkable for a continuous murmur on the upper right side of the sternum. She underwent stroke workup including MRI of the brain, carotid ultrasound and CT angiogram of the head and neck that were normal. Electrocardiography was normal. Transesophageal echocardiogram was performed to evaluate for possible paradoxical embolism which showed enlarged left main coronary artery measuring 2 cm in diameter with turbulence and increased flow velocities. An abnormal large, tortuous vessel was noted at the base of the heart draining into the right atrium with continuous left to right shunt. Coronary computed tomography was performed for further investigation that revealed an extremely large left main coronary artery which arises from the left coronary cusp. A markedly enlarged fistula vessel originating from the left main coronary artery was seen making a tortuous course posterior to the aorta and inferior to the pulmonary artery and feeding into the right atrium. This was consistent with a left main coronary artery to right atrium fistula. Patient underwent cardiac catheterization and fistula was successfully occluded without any complications.
Email: elshershari@hotmail.com