A hidden cause of hemoptysis: coronary artery-to-pulmonary parenchyma fistula


Kul Ş. , Canga Y., Guvenc T. S. , Sahin S.

TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY, cilt.39, ss.686-689, 2011 (ESCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 39 Konu: 8
  • Basım Tarihi: 2011
  • Doi Numarası: 10.5543/tkda.2011.01693
  • Dergi Adı: TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY
  • Sayfa Sayıları: ss.686-689

Özet

A 60-year-old man presented with complaints of chronic hemoptysis present for many years and a six-month history of chest pain. Physical examination showed a grade II/VI continuous murmur at the left sternal border. Electrocardiography showed normal sinus rhythm and nonspecific ST-T changes in lateral leads. Echocardiography showed mild left ventricular hypertrophy. Exercise test was discontinued because of anginal symptoms and occurrence of lateral ST depression. Hemoptysis was observed a few times during hospitalization. Computed tomography of the thorax showed no abnormality to explain hemoptysis. Coronary angiography revealed a critical lesion in the left anterior descending artery and a large, tortuous right coronary artery with a fistulization tract originating from its proximal region and draining into the left lung parenchyma. The lesion in the left anterior descending artery was stented and percutaneous coil embolization of the fistula was performed in another session. Coronary angiography showed complete occlusion of the fistula and no residual shunting. In the six-month period after the procedure, the patient was free of symptoms of angina and hemoptysis.