Recurrent Myocardial Infarction in a Patient with an Arteriovenous Coronary Fistula and No Coronary Artery Disease

Abstract

Myocardial infarction in the absence of coronary artery disease is a rare finding. Mechanisms leading to infarction include paradoxical embolism, coronary dissection, coronary spasm, hypercoagulable states, vasculitis, or—in presence of a coronary fistula—a steal phenomenon. We report for the first time a case of a patient with an arteriovenous coronary fistula and no coronary artery disease, suffering from three incidents of myocardial infarction in three different coronary regions—of which only one was located in the area supplied by the coronary artery connected to the fistula.

Keywords

myocardial infarction - coronary fistula - coronary spasm - coagulation

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