Tufan Çınar
1*, Yavuz Karabağ
2, İbrahim Rencuzogullari
2, Metin Cağdaş
21 Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey
2 Kafkas University Medical School, Department of Cardiology, Kars, Turkey
*Corresponding Author: *Corresponding Author: Tufan Çınar, MD; Sultan Abdülhamid Han Training and Research Hospital, Tibbiye St., Uskudar, Istanbul, Turkey. Tel: +90-21-65422020; Fax: +90-21-65422010; Email: , Email:
drtufancinar@gmail.com
Abstract
Coronary artery fistulas (CAFs) are described as abnormal communications between a coronary artery and cardiac chambers, or other vascular structures. The two types of CAFs are defined as type I (singular fistula) and type II (microfistulas). Even though various electrocardiographic changes have been previously described in CAF patients, coronary-artery microfistulas causing ST-segment elevation in diverse locations have not been reported. We describe a case report of an adult patient who presented with acute inferior myocardial infarction due to coronary-artery microfistulas. During the hospital stay, the patient re-experienced chest pain, and control electrocardiography revealed ST-segment elevation in the I and AVL leads along with reciprocal ST-segment depression in the inferior precordial leads. Although CAFs are clinically rare, they can have important clinical consequences. Microfistulas should be kept in mind as a cause of ST elevation myocardial infarction in some patients.