Pediatr Cardiol 12:227-228, 1991
Pediatric Cardiology 9 Springer-VerlagNew York Inc. 1991
Case Reports Failure o f C o l o r F l o w M a p p i n g to I d e n t i f y C o r o n a r y A r t e r y to P u l m o n a r y A r t e r y Fistula Thomas R. Lloyd Department of Pediatrics (Cardiology), University Heart Center, Children's Research Center, University of Arizona College of Medicine, Tucson, Arizona, USA
SUMMARY. A case of coronary artery to pulmonary artery fistula presented with the typical clinical findings of asymptomatic precordial continuous murmur and small left-to-right shunt. Echocardiography with color flow mapping failed to demonstrate the fistula on three occasions, including one study performed after angiographic demonstration of the fistula site. This case illustrates the importance of angiography in patients with unexplained continuous murmurs, even when echocardiographic and color flow mapping results are normal. KEY WORDS: Coronary artery fistula - - Pulmonary artery fistula - - Color flow mapping
Color flow mapping has identified coronary artery fistulas to the left ventricle [7], right ventricle [5, 6, 9-11], right atrium [2-4, 8, 9, 11], and pulmonary artery [9]. Although false-positive diagnosis of coronary-cameral fistula by color flow mapping has been reported [3], this report details the first case in which color flow mapping was unable to identify a coronary-cameral fistula despite presence of the typical continuous murmur.
Case Report A 6-year-old girl was referred for cardiologic evaluation because of an unusual murmur first heard during an influenza-like illness. A multicomponent murmur was heard, and two-dimensional and Doppler echocardiography including color flow mapping identified only a small pericardial effusion. At examination 3 months later, a continuous murmur was heard in the pulmonic area. The chest radiogram and electrocardiogram were normal. Echocardiography with color flow mapping was repeated, specifically searching for coronary artery fistulas. Again, results were normal, including normal diameters of the proximal right and left coronary arteries. At cardiac catheterization, intracardiac pressures were normal and a small (
Pediatric Cardiology 9 Springer-VerlagNew York Inc. 1991
Case Reports Failure o f C o l o r F l o w M a p p i n g to I d e n t i f y C o r o n a r y A r t e r y to P u l m o n a r y A r t e r y Fistula Thomas R. Lloyd Department of Pediatrics (Cardiology), University Heart Center, Children's Research Center, University of Arizona College of Medicine, Tucson, Arizona, USA
SUMMARY. A case of coronary artery to pulmonary artery fistula presented with the typical clinical findings of asymptomatic precordial continuous murmur and small left-to-right shunt. Echocardiography with color flow mapping failed to demonstrate the fistula on three occasions, including one study performed after angiographic demonstration of the fistula site. This case illustrates the importance of angiography in patients with unexplained continuous murmurs, even when echocardiographic and color flow mapping results are normal. KEY WORDS: Coronary artery fistula - - Pulmonary artery fistula - - Color flow mapping
Color flow mapping has identified coronary artery fistulas to the left ventricle [7], right ventricle [5, 6, 9-11], right atrium [2-4, 8, 9, 11], and pulmonary artery [9]. Although false-positive diagnosis of coronary-cameral fistula by color flow mapping has been reported [3], this report details the first case in which color flow mapping was unable to identify a coronary-cameral fistula despite presence of the typical continuous murmur.
Case Report A 6-year-old girl was referred for cardiologic evaluation because of an unusual murmur first heard during an influenza-like illness. A multicomponent murmur was heard, and two-dimensional and Doppler echocardiography including color flow mapping identified only a small pericardial effusion. At examination 3 months later, a continuous murmur was heard in the pulmonic area. The chest radiogram and electrocardiogram were normal. Echocardiography with color flow mapping was repeated, specifically searching for coronary artery fistulas. Again, results were normal, including normal diameters of the proximal right and left coronary arteries. At cardiac catheterization, intracardiac pressures were normal and a small (
