Spontaneous rupture of a coronary artery fistula presenting with post-exertional syncope and haemopericardium

Manan H Desai; Laura J Olivieri; Karthik V Ramakrishnan; Tacy E Downing

doi:10.1093/icvts/ivaa317

Spontaneous rupture of a coronary artery fistula presenting with post-exertional syncope and haemopericardium

Interact Cardiovasc Thorac Surg. 2021 Apr 19;32(4):658-660. doi: 10.1093/icvts/ivaa317.

Authors

Manan H Desai^{1

2}, Laura J Olivieri³, Karthik V Ramakrishnan^{1

4}, Tacy E Downing³

Affiliations

¹ Division of Cardiac Surgery, Children's National Hospital, Washington, DC, USA.
² Division of Pediatric Cardiothoracic Surgery, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA.
³ Division of Cardiology, Children's National Hospital, Washington, DC, USA.
⁴ Division of Pediatric Cardiothoracic Surgery, Children's National Hospital, Washington, DC, USA.

Abstract

An 8-year-old with a known diagnosis of an asymptomatic coronary artery fistula (CAF) presented with exertional syncope and haemopericardium due to contained rupture of CAF. A transcatheter closure was attempted, but the fistula ruptured again prompting emergency surgical repair. Spontaneous rupture is a catastrophic complication of CAF and warrants a high index of suspicion, timely diagnosis and team management.

Keywords: Coronary artery fistula; Haemopericardium; Syncope.

Publication types

Case Reports

MeSH terms

Child
Coronary Angiography
Coronary Vessel Anomalies
Fistula
Humans
Pericardial Effusion* / diagnostic imaging
Pericardial Effusion* / etiology
Pericardial Effusion* / surgery
Rupture, Spontaneous
Syncope / etiology
Treatment Outcome