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RMU

Uruguayan Medical Journal

ISSN: 1688-0390


Vol.19 - Nº 3 - Dic. 2003

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Assessment of patients with multiple coronary ventricular fistulas

DURAN A; MICHELIS V; DIAZ P; LUJAMBIO M; KUSTER F; LLUBERAS R; ROMERO CE
Rev Med Urug 2003; 19: 237-241
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract

Abstract

We describe four women with angina pectoris and positive functional tests using cineangiocoronarygraphy, multiple coronary ventricular fistulas were found but no obstructive injuries were seen. Stress testing by bicycle ergometer was assessed by a modificated Bruce protocol.

Three cases underwent a MIBI myocardial scintigraphy with progressive exercise test and the remainder underwent dipyridamole-thalium imaging. Multiple coronary ventricular fistulas is an alteration of coronary circulation that includes an abnormal communication between coronary arteries and a cardiac camera characterized by multiple fistulas of small caliber. They are also known as generalized myocardial microfistulas. Estimated prevalence is lower than 0.2%. Angina is the main symptom, coronary steal is supposed to be the physiopathologic mechanism, but cases with recorded ischemia are rare. We agree with the description appeared in international literature of patients with angor, positive functional tests and no obstructive coronary injuries, where multiple coronary ventricular fistulas are indicated as causing this symptomatology.