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- Koji Sato, Ikuo Misumi, Miwa Nagano, Ryohei Arima, Shota Ehara, Takashi Sakamoto, Hiroki Usuku, Koichi Kaikita, and Kenichi Tsujita.
- Department of Cardiology, Kumamoto City Hospital, Japan.
- Intern. Med. 2021 Dec 1; 60 (23): 3755-3758.
AbstractA 78-year-old woman was referred to our hospital because of repetitive suppurative arthritis at the artificial left knee joint. Her plasma brain natriuretic peptide level was 122 pg/mL. A 12-lead electrocardiogram showed a QS pattern in the inferior leads. A two-dimensional echocardiogram revealed hypokinesis at the inferior wall and hypertrophy at the apical lateral wall. Color flow imaging revealed this hypertrophic region to be a myocardial sinusoid, demonstrating diastolic coronary to left ventricular flow and early systolic flow vice versa. This was a very rare case of coronary to left ventricular fistula through a sinusoid without cyanotic congenital heart disease or severe coronary artery disease.
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