A case report of coronary pulmonary artery fistula detected by transthoracic echocardiography in an elderly patient with dyspnea.

Autor:	Truong T; Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam., Nguyen HTT; Cho Ray Hospital, Ho Chi Minh City, Vietnam., Phan VTX; Kansai Medical University, Hirakata, Osaka, Japan., Ly MHP; Children's Hospital No. 1, Ho Chi Minh City, Vietnam., Phan VTT; Jacobi Medical Center, The Bronx, NY, USA., Phan TA; Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam., Phan HH; University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam., Tran P; Nam Can Tho University, School of Medicine, Can Tho, Vietnam.
Jazyk:	angličtina
Zdroj:	AME case reports [AME Case Rep] 2021 Jan 25; Vol. 5, pp. 10. Date of Electronic Publication: 2021 Jan 25 (Print Publication: 2021).
DOI:	10.21037/acr-20-100
Abstrakt:	Coronary pulmonary artery fistula (CPAF) is a rare entity in the population. It may present with multiple clinical settings and in various age ranges. Invasive coronary angiography (ICA), coronary computed tomography angiography (CCTA), and transthoracic echocardiography (TTE) have been reported as diagnostic tools for CPAF. Among them, TTE is rarely capable of identifying CPAF. There is no current treatment guideline as some of the interventional therapies are effective yet controversial. The therapy therefore should be individualized. We report a case of CPAF accidentally detected by TTE in a 93-year-old female who presented with acute respiratory distress on the setting of community-acquired pneumonia, diastolic heart failure, ischemic heart disease, pulmonary hypertension, chronic kidney disease, and hypertension. The patient presented with orthopnea, fever, bilateral pleuritic chest pain, and productive cough with yellowish sputum for 7 days. She had no previous chest trauma or surgical intervention. TTE demonstrated the tortuous enlargement of left coronary artery which drains into the pulmonary arterial trunk right above the pulmonary valve. As the patient was in advanced age with multiple comorbidities; we offered a conservative management including diuretic, oxygen therapy, antibiotic, antiplatelet, and statin. She recovered following a 13-day hospitalization. To our knowledge, this is the oldest case report of suspected congenital CPAF which is particularly detected by TTE. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/acr-20-100). The authors have no conflicts of interest to declare. (2021 AME Case Reports. All rights reserved.)
Databáze:	MEDLINE
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