Myocardial Perfusion and Angina Improvement Following Allopurinol Therapy in a Patient With Coronary Artery Fistula.

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 sympto

SUBMITTER: Ziotti SDV 

PROVIDER: S-EPMC12462133 | biostudies-literature | 2025 Aug

REPOSITORIES: biostudies-literature