Coronary Artery Fistula Differential Diagnoses

Updated: Jan 27, 2015
  • Author: Monesha Gupta, MD, MBBS, FAAP, FACC, FASE; Chief Editor: Stuart Berger, MD  more...
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DDx

Diagnostic Considerations

Other conditions to consider in the differential diagnosis of coronary artery fistula include the following:

  • Ruptured sinus of Valsalva aneurysm

  • Ventricular septal defect with aortic insufficiency

  • Venous hums

  • Intrathoracic systemic fistulae

  • Congenital systemic fistula to the pulmonary vein

  • Pulmonary arteriovenous malformation

  • Aortopulmonary window

  • Congenital or acquired pulmonary vein stenosis

Important considerations

Be aware of coronary artery fistula to avoid missing the diagnosis.

Realize that conservative management may be appropriate in some patients, because spontaneous closure occurs in 23% of small fistulae, primarily those arising from the left coronary system.

Advise patients that they should receive appropriate antibiotics for any dental, oropharyngeal, gastrointestinal tract, or urologic surgical procedures if associated with a cyanotic heart disease.

Differential Diagnoses