CASE REPORT article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1664375
This article is part of the Research TopicCase Reports in Coronary Artery Disease: 2025View all 10 articles
Case report: A rare case of coronary artery anomaly (right coronary artery-pulmonary artery fistula with diffuse dilatation)
Provisionally accepted
- 1The 920th Hospital of the Chinese People's Liberation Army, Yunnan, China
- 2920th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China, Kunming, China
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Congenital coronary artery anomalies (CAAs) are rare cardiovascular disorders that often present with non-specific symptoms, making diagnosis and treatment particularly challenging. These anomalies can occur in various forms, including anomalous origin of a coronary artery, coronary artery fistula, and coronary artery tortuosity, among others. The lack of specific symptoms often leads to delayed diagnosis, which can have significant implications for patient outcomes. In addition, the treatment options for CAAs vary depending on the type and severity of the anomaly, posing further therapeutic challenges for healthcare providers.This case report describes a 39-year-old male presenting with heart failure secondary to a giant right coronary artery-pulmonary artery fistula (RCA-PA fistula) accompanied by diffuse aneurysmal dilatation. The patient exhibited acute decompensated heart failure, atrial fibrillation, and severe left ventricular enlargement, initially misattributed to valvular disease. Coronary angiography and surgical exploration confirmed a tortuous, dilated RCA fistula draining into the pulmonary artery, with diffuse aneurysmal changes compromising myocardial perfusion. Due to the complexity of aneurysmal anatomy and high surgical risk, conservative management was adopted, leading to symptomatic improvement.This case highlights the need for heightened clinical suspicion of CAAs in young patients with atypical heart failure and emphasizes multidisciplinary strategies for managing complex coronary malformations.
Keywords: Coronary artery anomalies, Coronary Aneurysm, Coronary fistula, Coronary Angiography, Heart failure Coronary artery anomalies, Heart Failure
Received: 11 Jul 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Wang, Yu, Chen, Yang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoming Wang, The 920th Hospital of the Chinese People's Liberation Army, Yunnan, China
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