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A Case of Coronary Artery-Left Ventricular Multiple Microfistulas with Catastrophic Clinical Consequence

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A 84-year-old male who visited our hospital with resting dyspnea was diagnosed as congestive heart failure. Decreased systolic function and regional wall motion abnormality on the left anterior descending artery territory were observed on transthoracic echocardiography. Coronary angiogram showed no significant coronary artery stenosis. However, there were multiple microfistulas connecting the left anterior descending artery and left ventricle. After receiving optimal medical therapy, the patient showed improvement and was discharged. However, he expired four months later due to recurrent heart failure.

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