Multiple coronary artery-left ventricle fistulas in a patient with apical hypertrophic cardiomyopathy: an unusual cause of angina pectoris
Lisanti, P.; Serino, W.; Petrone, M.
Giornale Italiano di Cardiologia 18(10): 858-861
1988
ISSN/ISBN: 0046-5968 PMID: 3246319 Document Number: 322356
A 50 year-old man had a history of crescendo exertional angina. Echocardiographic and electrocardiographic findings were typical of apical hypertrophic cardiomyopathy. Selective coronary angiography showed no atherosclerotic lesions, but there was a stream of dye into the left ventricle, via a tiny plexus of intramural vessels, from the distal third of the anterior descending coronary artery. The origin of myocardial ischemia has been related to a "steal" phenomenon, while this vascular anomaly could represent a disorder of the thebesian system, possibly due to the "disarray" of myocardial cells typical of hypertrophic cardiomyopathy.