Melola Discovery

← Melola Discovery

Akses terbuka Jurnal SINTA 1

When coronary anomalies induce arrhytmias: A case of ventricular tachycardia due to left coronary artery-pulmonary artery fistula

Heart Science Journal · Vol. 6 No. 3 (2025)

DOI
10.21776/ub.hsj.2025.006.03.20
ISSN
2721-9984, 2721-9976
Terbit
2025-07-31
Penerbit
Universitas Brawijaya
Bahasa
en
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Coronary artery fistula (CAF) is a rare vascular anomaly involving an abnormal connection between a coronary artery and another cardiac or vascular structure. Although often asymptomatic, CAF can cause myocardial ischemia, presenting as angina, dyspnea, or ventricular arrhythmias, due to flow diversion, leading to a coronary stealing phenomenon that poses a serious clinical challenge. Case: An 81-year-old female presented with chest pain, palpitations, and syncope. Electrocardiography (ECG) showed monomorphic VT, successfully cardioverted and managed with amiodarone. Following initial stabilization, she experienced recurrent episodes of VT that were terminated with lidocaine. Physical examination revealed a continuous machinery murmur at the left upper sternal border. Transthoracic echocardiography showed left coronary artery dilation with turbulent flow into the pulmonary artery. Aortography and coronary angiography confirmed a dilated left main coronary artery with an aneurysmal segment and a tortuous fistulous tract to the pulmonary artery. Computed tomography coronary angiography (CTCA) with 3D reconstruction confirmed a left coronary artery fistula to the pulmonary artery. Conclusion: This case highlights CAF as an uncommon yet clinically important etiology of recurrent VT, likely attributable to the coronary stealing phenomenon. Multimodal imaging, especially CTCA, is crucial for diagnosis and treatment planning. In addition to immediate management with cardioversion/defibrillation and antiarrhythmic drugs, treatment of ischemia as the underlying cause is important in the management of ischemia-induced VT. CAF closure is recommended in symptomatic or hemodynamically significant CAF to alleviate ischemic symptoms and prevent complication.

Kata kunci

Jaringan kolaborasi para penulis

40 penulis · 253 tautan kepenulisan bersama · menampilkan 40 yang paling banyak terhubung

Arahkan kursor atau ketuk sebuah nama untuk menyorot rekan penulisnya. Klik dua kali untuk membuka halaman penulis.

  • University of Brawijaya
  • Afiliasi tidak diketahui
  • Organisasi berbeda
  • Organisasi sama
  • Afiliasi tidak diketahui
  • Garis lebih tebal = lebih banyak artikel bersama · lingkaran lebih besar = lebih banyak artikel
Tampilkan sebagai tabel
Rekan penulisOrganisasiArtikel bersama
Mohammad Saifur RohmanAfiliasi tidak diketahui22
Anna Fuji RahimahAfiliasi tidak diketahui20
Indra PrasetyaAfiliasi tidak diketahui14
Novi KurnianingsihAfiliasi tidak diketahui11
Setyasih AnjarwaniAfiliasi tidak diketahui11
Sasmojo WiditoAfiliasi tidak diketahui10
Heny MartiniAfiliasi tidak diketahui10
Djanggan SargowoAfiliasi tidak diketahui6
Cholid Tri TjahjonoAfiliasi tidak diketahui6
Valerinna YogibuanaAfiliasi tidak diketahui6
Adhika Prastya WikanandaAfiliasi tidak diketahui5
Yoga WaranugrahaAfiliasi tidak diketahui5
Vemmy Lian SaputriAfiliasi tidak diketahui4
Budi SatrijoAfiliasi tidak diketahui3
Icmi Dian RochmawatiAfiliasi tidak diketahui3
Valerinna Yogibuana Swastika PutriAfiliasi tidak diketahui3
Nikhen NoverikeAfiliasi tidak diketahui3
Puspa LestariAfiliasi tidak diketahui2
Olivia HandayaniAfiliasi tidak diketahui2
Fahmy RusnantaAfiliasi tidak diketahui2
Anita Surya SantosoAfiliasi tidak diketahui2
Fitranti Suciati LaitupaAfiliasi tidak diketahui2
Muhammad Saifur RohmanAfiliasi tidak diketahui2
Diah Ivana SariAfiliasi tidak diketahui2
Tri AstiawatiAfiliasi tidak diketahui2
Cik KahadiAfiliasi tidak diketahui2
Dion SetiawanAfiliasi tidak diketahui2
Muhammad FirdausAfiliasi tidak diketahui2
Nur Kaputrin DwigustiningrumAfiliasi tidak diketahui2
Veny KurniawatiAfiliasi tidak diketahui1
Putri Annisa KamilaUniversity of Brawijaya1
Aditha Satria MaulanaAfiliasi tidak diketahui1
Jonny Karunia FajarAfiliasi tidak diketahui1
Aris Munandar Zulkifli IsmailAfiliasi tidak diketahui1
Aris Munandar ZIAfiliasi tidak diketahui1
Tonny AdriyantoAfiliasi tidak diketahui1
Seprian WidasmaraAfiliasi tidak diketahui1

Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.

Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">When coronary anomalies induce arrhytmias: A case of ventricular tachycardia due to left coronary artery-pulmonary artery fistula</dc:title>
	<dc:creator xml:lang="en">Saerang, Gebryel Dennis</dc:creator>
	<dc:creator xml:lang="en">Rizal, Ardian</dc:creator>
	<dc:creator xml:lang="en">Karolina, Wella</dc:creator>
	<dc:subject xml:lang="en">Coronary Artery Fistula</dc:subject>
	<dc:subject xml:lang="en">Ventricular Tachycardia</dc:subject>
	<dc:subject xml:lang="en">CT Coronary Angiography</dc:subject>
	<dc:subject xml:lang="en">Coronary Stealing Phenomenon</dc:subject>
	<dc:description xml:lang="en">Background: Coronary artery fistula (CAF) is a rare vascular anomaly involving an abnormal connection between a coronary artery and another cardiac or vascular structure. Although often asymptomatic, CAF can cause myocardial ischemia, presenting as angina, dyspnea, or ventricular arrhythmias, due to flow diversion, leading to a coronary stealing phenomenon that poses a serious clinical challenge.
Case: An 81-year-old female presented with chest pain, palpitations, and syncope. Electrocardiography (ECG) showed monomorphic VT, successfully cardioverted and managed with amiodarone. Following initial stabilization, she experienced recurrent episodes of VT that were terminated with lidocaine. Physical examination revealed a continuous machinery murmur at the left upper sternal border. Transthoracic echocardiography showed left coronary artery dilation with turbulent flow into the pulmonary artery. Aortography and coronary angiography confirmed a dilated left main coronary artery with an aneurysmal segment and a tortuous fistulous tract to the pulmonary artery. Computed tomography coronary angiography (CTCA) with 3D reconstruction confirmed a left coronary artery fistula to the pulmonary artery.
Conclusion: This case highlights CAF as an uncommon yet clinically important etiology of recurrent VT, likely attributable to the coronary stealing phenomenon. Multimodal imaging, especially CTCA, is crucial for diagnosis and treatment planning. In addition to immediate management with cardioversion/defibrillation and antiarrhythmic drugs, treatment of ischemia as the underlying cause is important in the management of ischemia-induced VT. CAF closure is recommended in symptomatic or hemodynamically significant CAF to alleviate ischemic symptoms and prevent complication.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2025-07-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20351</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2025.006.03.20</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visualization</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2025.006.03</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20351/518</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2025 Gebryel Dennis Saerang, Ardian Rizal, Wella Karolina</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>