Coronary Fistula As A Cause Of Coronary Ischemia In Geriatric Age

Coronary fistulas are abnormal connections which form between coronary arteries and cardiac chambers or other vessels. Fistulas are frequently congenital and sometimes may be acquired. In 9% of the cases the symptoms appear before the age of 20. After the age of 20, 55% of the cases become symptomatic. The rate of being symptomatic increases further in advanced ages. The symptoms may be related with coronary ischemia, pumonary hypertension, heart failure or arrhthymia. The mechanism of coronary ischemia may be related with the phenomenon of coronary steal or runoff. Although the symptoms are frequently related with coronary ischemia in the geriatric age group, most symptoms which occur before the age of 20 are related with left-to-right shunt. The aim of the presentation of this patient was to examine the pathophysiology of occurence of a congenital coronary fistula with angina, ischemia and dyspnea in the geriatric age after staying asymptomatic for years.