Case report: Right coronary artery to left ventricular fistula complicated with coronary artery dilation presenting as persistent cardiogenic ischemic chest pain

Yuehai Wang; Yuqiang Zhang; Fei Wang; Yuzeng Xue

doi:10.3389/fcvm.2023.1238034

Case report: Right coronary artery to left ventricular fistula complicated with coronary artery dilation presenting as persistent cardiogenic ischemic chest pain

Front Cardiovasc Med. 2023 Sep 13:10:1238034. doi: 10.3389/fcvm.2023.1238034. eCollection 2023.

Authors

Yuehai Wang^#^{1

2}, Yuqiang Zhang^#^{1

2}, Fei Wang³, Yuzeng Xue¹

Affiliations

¹ Cardiology Department, Liaocheng People's Hospital of Shandong University and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, China.
² Laboratory Animal Center, Liaocheng People's Hospital of Shandong University and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, China.
³ Department of Cardiology, Shandong Corps Hospital of Chinese People's Armed Police Forces, Jinan, China.

^# Contributed equally.

Abstract

We reported a patient with a fistula of the right coronary artery to the left ventricle, accompanied by dilation of the right coronary artery and persistent chest pain. This patient underwent surgical fistula closure surgery, but the fistula recurred. Persistent chest pain reappeared after encountering COVID-19 infection. We analyzed the mechanism of persistent myocardial ischemic chest pain caused by coronary artery fistula in this patient, the impact of surgery on the patient's disease, the possible mechanism of COVID-19 causing persistent ischemic chest pain in this patient, and the possible mechanism of metoprolol in alleviating myocardial ischemic chest pain in this patient.

Keywords: COVID-19; coronary artery dilation; endothelin-1; ischemic chest pain; right coronary artery fistula; steal phenomenon; β-blocker.

Publication types

Case Reports

Grants and funding

This study was supported by Shandong Province Traditional Chinese Medicine Science and Technology Development Plan Project (No. 20190906). This article is also one of the achievements of the Social Science Planning Topic of Liaocheng (NDYB2023012).