Nonhemorrhagic Pericardial Effusion With Tamponade and Cardiogenic Shock Due to Large Coronary Artery Fistula.

ABSTRACT:

Background

Coronary artery fistulas (CAFs) are a rare congenital heart disease. Large fistulas can lead to coronary steal phenomena presenting with angina, heart failure, and in rare cases, cardiogenic shock.

Case summary

A 55-year-old woman acutely presented at our heart center with nonhemorrhagic pericardial tamponade and cardiogenic shock. A large CAF of an aneurysmatic right coronary artery to the coronary sinus was diagnosed. Pericardiocentesis was used for initial hemodynamic stabilization. On cardiopulmonary bypass, perforations connecting right coronary artery and coronary sinus were closed via suture.

Discussion

In cases of CAF, cardiogenic shock with pericardial tamponade is usually caused by rupture of an aneurysmatic vessel with successive hemopericardium.

SUBMITTER: von Sanden F 

PROVIDER: S-EPMC11911894 | biostudies-literature | 2025 Mar

REPOSITORIES: biostudies-literature