Year: 2026
Type: article
Study design: Case Report
Abstract: An 82-year-old woman visited our hospital because of chest pain that she had been experiencing since her teenage years. A 12-lead electrocardiogram showed a flat T-wave in leads V4-V6. Transthoracic echocardiography revealed normal left ventricular (LV) wall motion. At the apex, color Doppler echocardiography demonstrated an unusual myocardial flow pattern, directed from the epicardium to the LV lumen during diastole and reversing during systole, findings diagnostic of a myocardial sinusoid. Cardiac computed tomography (CCT) revealed interruption of the left anterior descending artery. Rest myocardial perfusion imaging derived from CCT revealed a unique finding of hyperperfusion during diastole and hypoperfusion during systole at the sinusoid. These findings demonstrate the utility of CCT in identifying coronary artery ventricle fistulas.
Authors: Ikuo Misumi, Koji Sato, Kazuhiko Fujii, Hiroki Usuku, Kenichi Tsujita
Institutions: Kumamoto City Hospital, Kumamoto University
Language: English
Topic: Coronary Artery Anomalies
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7140159923
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