Coronary Fistula-Induced Ventricular Tachycardia From Thrombotic Cyst Compression: A Case Report.

ABSTRACT:

Background

Coronary artery fistula (CAF) complicated by thrombotic cyst formation is a rare cause of ventricular tachycardia (VT), involving ischemia and mechanical compression.

Case presentation

A 55-year-old woman presented with palpitations, chest pain, monomorphic VT (negative V1-V6), and elevated troponin I. Imaging revealed a large right ventricular cyst. Surgical resection confirmed a thrombotic cyst communicating with a CAF. Postoperative VT recurred, leading to cardiogenic shock and death.

Conclusions

CAF-related thrombotic cysts can cause irreversible myocardial fibrosis, creating a persistent VT substrate unresponsive to anatomical intervention alone. ECG markers (fragmented QRS, ST depression) reflect irreversible damage.

SUBMITTER: Lu X 

PROVIDER: S-EPMC12586343 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature