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VOLUME 25 , ISSUE 3 ( March, 2021 ) > List of Articles

CASE REPORT

An Incidental Finding of Coronary-cameral Fistulas in a Critically Ill Patient with a Metastatic Cardiac Tumor

Braghadheeswar Thyagarajan, Casey Bryant, Ashish K Khanna

Keywords : Cardiac tumor, Coronary-cameral fistulas, Metastatic melanoma

Citation Information : Thyagarajan B, Bryant C, Khanna AK. An Incidental Finding of Coronary-cameral Fistulas in a Critically Ill Patient with a Metastatic Cardiac Tumor. Indian J Crit Care Med 2021; 25 (3):340-342.

DOI: 10.5005/jp-journals-10071-23768

License: CC BY-NC 4.0

Published Online: 20-03-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

It is extremely rare for a cardiac tumor to present with coronary-cameral fistulas. A 66-year-old Caucasian male presented with worsening dyspnea and subsequently had a cardiac catheterization for an ST-elevation myocardial infarction, revealing no evidence of coronary artery disease but multiple coronary-cameral fistulas. Venoarterial (VA) extracorporeal membrane oxygenation was initiated for a severe cardiogenic shock. Workups including a transesophageal echocardiography and a right heart catheterization led to a diagnosis of metastatic melanoma involving both ventricles of his heart. Angiogenesis is well described in melanomas and our novel case reports the extremely rare association of coronary-cameral fistulas with a metastatic cardiac melanoma.


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  1. Hoffmeier A, Sindermann JR, Scheld HH, Martens S. Cardiac tumors—diagnosis and surgical treatment. Dtsch Arztebl Int 2014;111(12):205–211. DOI: 10.3238/arztebl.2014.0205.
  2. Raju MG, Goyal SK, Punnam SR, Shah DO, Smith GF, Abela GS. Coronary artery fistula: a case series with review of the literature. J Cardiol 2009;53(3):467–472. DOI: 10.1016/j.jjcc.2008.09.009.
  3. Subash S, Thimmarayappa A, Patel GP, Dhananjaya M, Gopal D, Manjunatha N. A rare case of left atrial myxoma vascularity causing acquired coronary cameral fistula: role of transesophageal echocardiography. Heart Views 2018;19(1):12–15. DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_79_17.
  4. Said SA, Werner HA, Veerbeek A. Coronary-cameral fistula in association with intracardiac tumour and aortic stenosis in an adult. Int J Cardiol 1991;33(1):159–162. DOI: 10.1016/0167-5273(91)90164-k.
  5. Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol 2007;60(1):27–34. DOI: 10.1136/jcp.2005.035105.
  6. Allen BC, Mohammed TL, Tan CD, Miller DV, Williamson EE, Kirsch JS. Metastatic melanoma to the heart. Curr Probl Diagn Radiol 2012;41(5):159–164. DOI: 10.1067/j.cpradiol.2011.09.001.
  7. Goldberg AD, Blankstein R, Padera RF. Tumors metastatic to the heart. Circulation 2013;128(16):1790–1794. DOI: 10.1161/CIRCULATIONAHA.112.000790.
  8. Liberthson RR, Sagar K, Berkoben JP, Weintraub RM, Levine FH. Congenital coronary arteriovenous fistula. Report of 13 patients, review of the literature and delineation of management. Circulation 1979;59(5):849–854. DOI: 10.1161/01.cir.59.5.849.
  9. Mahabeleshwar GH, Byzova TV. Angiogenesis in melanoma. Semin Oncol 2007;34(6):555–565. DOI: 10.1053/j.seminoncol.2007.09.009.
  10. Mugge A, Daniel WG, Haverich A, Lichtlen PR. Diagnosis of noninfective cardiac mass lesions by two-dimensional echocardiography. Comparison of the transthoracic and transesophageal approaches. Circulation 1991;83(1):70–78. DOI: 10.1161/01.cir.83.1.70.
  11. Sutsch G, Jenni R, von Segesser L, Schneider J. Heart tumors: incidence, distribution, diagnosis. Exemplified by 20,305 echocardiographies. Schweizerische medizinische Wochenschrift 1991;121(17):621–629. PMID: 2047823.
  12. O'Donnell DH, Abbara S, Chaithiraphan V, Yared K, Killeen RP, Cury RC, et al. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol 2009;193(2):377–387. DOI: 10.2214/AJR.08.1895.
  13. Reinhardt MJ, Joe AY, Jaeger U, Huber A, Matthies A, Bucerius J, et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol 2006;24(7):1178–1187. DOI: 10.1200/JCO.2005.03.5634.
  14. Boyle S, Jesuthasan LSB, Jenkins C, Challa P, Ranjan S, Dahiya A. Coronary-Cameral fistula. Circ Cardiovasc Imaging 2019;12(5):e008691. DOI: 10.1161/CIRCIMAGING.118.008691.
  15. Aerts BR, Kock MC, Kofflard MJ, Plaisier PW. Cardiac metastasis of malignant melanoma: a case report. Neth Heart J 2014;22(1):39–41. DOI: 10.1007/s12471-013-0441-8.
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