Aortocaval fistula presenting as Type 2 acute myocardial infarction in a patient with severe arteriopathy
- Resource Type
- Authors
- Alice Sawka; Vivekanand Rajendran; Krishnaswamy Sundararajan
- Source
- Indian Journal of Critical Care Medicine. 22:372-374
- Subject
- Acute coronary syndrome
medicine.medical_specialty
business.industry
Fistula
Signs and symptoms
030204 cardiovascular system & hematology
030230 surgery
Critical Care and Intensive Care Medicine
medicine.disease
digestive system
Abdominal aortic aneurysm
Pathophysiology
03 medical and health sciences
0302 clinical medicine
Internal medicine
Aortocaval fistula
cardiovascular system
Etiology
medicine
Cardiology
Myocardial infarction
business
- Language
- ISSN
- 1998-359X
0972-5229
Aortocaval fistulas (ACFs) are rare with varied etiologies. Symptoms can be acute or delayed with predominant manifestations being high output cardiac failure. Acute coronary syndrome due to ACF has not been widely reported. We present a case of a 68-year-old male who presented with signs and symptoms suggestive of acute coronary syndrome. This was confirmed by electrocardiogram changes and a rise in cardiac enzymes. A large abdominal aortic aneurysm was diagnosed initially by imaging without evidence of leak or rupture. A coronary angiogram showed only mild diffuse disease. On further reviewing, the computerized tomography imaging revealed an ACF. This was subsequently repaired with rapid improvement in his condition. Acute coronary syndrome is an unusual presentation of ACF with inadequately understood pathophysiological mechanisms. Prompt diagnosis and surgical management of this fistula are paramount to reduce mortality and morbidity.