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Multiple Coronary Artery-Left Ventricular Fistulas Associated With Hereditary Hemorrhagic Telangiectasia*

Mina A. Jacob, MD; Sanjeev B. Goyal, MD; Luigi Pacifico, MD; David H. Spodick, MD, DSc, FCCP
Author and Funding Information

*From the Department of Cardiology, University of Massachusetts-Saint Vincent Hospital, Worcester, MA.

Correspondence to: Sanjeev B. Goyal, MD, Department of Cardiology, University of Massachusetts-Saint Vincent Hospital, 20 Worcester Center Blvd, Worcester, MA 01608; e-mail: sangoy@pol.net



Chest. 2001;120(4):1415-1417. doi:10.1378/chest.120.4.1415
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Coronary artery-left ventricular (LV) fistulas are extremely rare and can cause myocardial ischemia from coronary steal. We describe an elderly woman who presented with unstable angina from multiple and extensive coronary artery-LV fistulas. She also had clinical features suggestive of hereditary hemorrhagic telangiectasia (HHT). Association of coronary artery-LV fistulas with HHT has not been reported and can pose a management dilemma in view of the risks of extensive cardiopulmonary surgery and potential complications of myocardial ischemia, stroke, and brain abscess.

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