Dataset Information
Myocardial Perfusion and Angina Improvement Following Allopurinol Therapy in a Patient With Coronary Artery Fistula.
Ontology highlight
ABSTRACT: Background
Coronary artery fistulas (CAFs) can lead to ischemia and angina in the absence of obstructive coronary artery disease. There is no evidence supporting a noninterventional approach to improve ischemia or alleviate symptoms for patients with refractory angina associated with CAFs.Case summary
An 85-year-old woman presented with angina functional class 3 despite being on 3 antianginal medications. Myocardial scintigraphy showed reversible hypoperfusion in the left ventricle's lateral, inferolateral, and inferior walls. A coronary angiogram showed no obstructions; however, a CAF was found. Considering the patient's frailty and unsuitability for cardiac intervention, she was enrolled in a high-dose allopurinol protocol, which led to a significant improvement in symptoms, exercise capacity, and myocardial perfusion.Discussion
This case highlighted allopurinol as a potential alternative for alleviating ischemia and angina in patients with CAF deemed not good candidates for cardiac interventions.
SUBMITTER: Ziotti SDV
PROVIDER: S-EPMC12462133 | biostudies-literature | 2025 Aug
REPOSITORIES: biostudies-literature
Publications
Myocardial Perfusion and Angina Improvement Following Allopurinol Therapy in a Patient With Coronary Artery Fistula.
JACC. Case reports 20250801 23
<h4>Background</h4>Coronary artery fistulas (CAFs) can lead to ischemia and angina in the absence of obstructive coronary artery disease. There is no evidence supporting a noninterventional approach to improve ischemia or alleviate symptoms for patients with refractory angina associated with CAFs.<h4>Case summary</h4>An 85-year-old woman presented with angina functional class 3 despite being on 3 antianginal medications. Myocardial scintigraphy showed reversible hypoperfusion in the left ventric ...[more]