Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Coronary-Pulmonary Artery Fistula

관상동맥-폐동맥 누공 1예

  • Lee, Kyung Hae (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Wang, Joon Kwang (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Shin, Sung Joon (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Mi Ok (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Tae Hyung (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Son, Jang Won (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Yun, Ho Ju (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Shin, Dong Ho (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Park, Sung Soo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Kyung Soo (Department of Internal Medicine, Hanyang University College of Medicine)
  • 이경해 (한양대학교 의과대학 내과학교실) ;
  • 왕준광 (한양대학교 의과대학 내과학교실) ;
  • 신성준 (한양대학교 의과대학 내과학교실) ;
  • 김미옥 (한양대학교 의과대학 내과학교실) ;
  • 김태형 (한양대학교 의과대학 내과학교실) ;
  • 손장원 (한양대학교 의과대학 내과학교실) ;
  • 윤호주 (한양대학교 의과대학 내과학교실) ;
  • 신동호 (한양대학교 의과대학 내과학교실) ;
  • 박성수 (한양대학교 의과대학 내과학교실) ;
  • 김경수 (한양대학교 의과대학 내과학교실)
  • Published : 2004.04.30
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Abstract

Fistula between coronary artery and pulmonary artery is a type of coronary artery anomalies. It can cause atypical chest pain and fatigue, angina pectoris, endocarditis, finally myocardial steal can result in heart failure and myocardial infarction. But only 0.1-0.2% of coronary angiographic studies reveal the communications between coronary artery and other spaces. (heart chamber, pulmonary artery etc.) It is frequently congenital, but acquired types are increasing because chest and heart manipulations such as opertion of tetralogy of Fallot, endomyocardial biopsy, radiation therapy, or penetrating blunt trauma are increasing. There are reports about repair of fistula using thrombogenic tips, coil embolization and surgical intervention. We report a connection between coronary artery and pulmonary artery in 79 years old female. She was 30 pack-years smoker and suffered from dyspnea several years with chronic obstructive pulmonary disease. She presented with atypical chest pain and palpitation after admission. Electrocardiography showed ST-T wave abnormality. Emergency coronary angiography and chest CT scan revealed coronary-pulmonary artery fistula. Transcatheter embolization was performed and she was relieved from discomforts.

관상동맥-폐동맥 누공은 비교적 드문 질환으로 선천적 원인이 대부분이나 최근 흉부 시술이나 방사선 치료의 증가로 점차 후천적 원인이 많아지는 추세이다. 증상이 비특이적이어서 진단이 늦어질 수 있어 주의를 요한다. 저자들이 경험한 환자는 기존의 폐질환 증상 때문에 심장 혈관 질환의 진행을 예측하기 어려웠다. 약간의 논쟁이 있으나 원인에 계 없이 크기가 작은 누공에서는 추적관찰이, 중등도 이상의 크기이거나 확장 가능성이 있는 경우에는 누공을 막거나 원인혈관을 제거하는 방법이 장되고 있다. 예후는 대체로 양호한 편이다.

Keywords

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