Sudden Death Related to Left Anterior Descending Coronary Artery Fistula Draining to the Left Ventricle: A Case Report with Review of the Literature.

Cheong, Harin; Kyeong, Hee Eun; Kim, Jun Mo; Choi, Byung Ha; Chung, Nak Eun

Case Report

Korean Journal of Legal Medicine 2011;35(2):174-178.
Published online November 30, 2011.

Sudden Death Related to Left Anterior Descending Coronary Artery Fistula Draining to the Left Ventricle: A Case Report with Review of the Literature.

Harin Cheong, Hee Eun Kyeong, Jun Mo Kim, Byung Ha Choi, Nak Eun Chung

Division of Forensic Medicine, National Forensic Service, Seoul, Korea. damian21@korea.kr

Abstract

Coronary artery fistula (CAF) is a rare congenital malformation, comprising less than 1% of all congenital heart disease. Most fistulas drain into the right-sided heart chambers or pulmonary artery, and termination in left heart chambers is an uncommon finding. Clinical presentation mainly depends on the severity of the left-to-right shunt, and adult patients usually do not develop any symptom. There are few case reports relating CAF manifested as an exceptional form of sudden unexpected death. We experienced a case of a 62-year-old male with a single CAF arising from left main coronary artery which drains into the left ventricle, and reported with review of the related articles.

Key Words: coronary artery fistula, sudden death, cardiac hypertrophy, myocardial fibrosis