Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula

A 50-year-old female patient presented with a “dumbbell” giant right coronary artery ectasia, characterized by two artery dilation segments both reaching the level of a giant aneurysm with a normal segment between them. Computed tomography angiography showed a fistula sac in the right atrium. The ve...

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Main Authors: Jianggui Shan, Heng Wang, Song Xue
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1498359/full
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author Jianggui Shan
Heng Wang
Song Xue
author_facet Jianggui Shan
Heng Wang
Song Xue
author_sort Jianggui Shan
collection DOAJ
description A 50-year-old female patient presented with a “dumbbell” giant right coronary artery ectasia, characterized by two artery dilation segments both reaching the level of a giant aneurysm with a normal segment between them. Computed tomography angiography showed a fistula sac in the right atrium. The vessel shape was a typical type IV (localized or segmental) coronary artery ectasia, which is rarely seen on true imaging. The patient had a 3-year history of chest tightness, without dyspnea, worsened by physical activity. Additional tests indicated that she had mitral valve regurgitation, superficial myocardial bridge, and anemia, all of which led to the development of her symptoms. She felt relieved after successful coronary artery fistula repair, mitral valvuloplasty, and fistula sac removal. At the 6-month follow-up, no complications were found according to echocardiography. Patients with coronary aneurysms can be asymptomatic in the early stage, while this case indicates that the dumbbell shape may be a developing stage of giant coronary aneurysm whose origin and close-fistula segments are influenced by separate hydrodynamics during ectasia or aneurysm formation.
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spelling doaj-art-a99f1b03ea714666b15637a00b10cae52025-08-20T02:45:56ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-02-011210.3389/fcvm.2025.14983591498359Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistulaJianggui ShanHeng WangSong XueA 50-year-old female patient presented with a “dumbbell” giant right coronary artery ectasia, characterized by two artery dilation segments both reaching the level of a giant aneurysm with a normal segment between them. Computed tomography angiography showed a fistula sac in the right atrium. The vessel shape was a typical type IV (localized or segmental) coronary artery ectasia, which is rarely seen on true imaging. The patient had a 3-year history of chest tightness, without dyspnea, worsened by physical activity. Additional tests indicated that she had mitral valve regurgitation, superficial myocardial bridge, and anemia, all of which led to the development of her symptoms. She felt relieved after successful coronary artery fistula repair, mitral valvuloplasty, and fistula sac removal. At the 6-month follow-up, no complications were found according to echocardiography. Patients with coronary aneurysms can be asymptomatic in the early stage, while this case indicates that the dumbbell shape may be a developing stage of giant coronary aneurysm whose origin and close-fistula segments are influenced by separate hydrodynamics during ectasia or aneurysm formation.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1498359/fullcardiovascular surgerycase reportcomputed tomography angiographycoronary artery ectasiacoronary artery fistula
spellingShingle Jianggui Shan
Heng Wang
Song Xue
Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula
Frontiers in Cardiovascular Medicine
cardiovascular surgery
case report
computed tomography angiography
coronary artery ectasia
coronary artery fistula
title Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula
title_full Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula
title_fullStr Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula
title_full_unstemmed Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula
title_short Case Report: “Dumbbell” giant right coronary artery ectasia with right atrial fistula
title_sort case report dumbbell giant right coronary artery ectasia with right atrial fistula
topic cardiovascular surgery
case report
computed tomography angiography
coronary artery ectasia
coronary artery fistula
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1498359/full
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