RESUMEN
A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.
RESUMEN
Congenital coronary artery fistulas (CAFs) are rare and asymptomatic, although symptomatic CAFs should be treated with percutaneous intervention or surgery. A 62-year-old woman developed bilateral coronary-to-pulmonary artery fistulas resulting in exertional chest pain. We herein report the successful use of trans-catheter closure of a coronary artery-to-pulmonary artery fistula, which lead to the coronary steal phenomenon, using an Amplatzer vascular plug with the trans-radial approach. After the procedure, the patient remained asymptomatic.
