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10-03-2020 | Image Puzzle – Question | Uitgave 10/2020 Open Access

Netherlands Heart Journal 10/2020

Fistula from left main coronary artery to pulmonary trunk

Netherlands Heart Journal > Uitgave 10/2020
N. Papakonstantinou, N. Miaris, K. Argyrakis, S. Mitsiadis, A. Dimopoulos, G. Gavrielatos, N. Patsourakos, N. Kasinos, A. Theodosis-Georgilas, E. Pisimisis
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12471-020-01406-0) contains supplementary material, which is available to authorized users.
An 81-year-old male patient with past medical history of arterial hypertension and diabetes mellitus presented to our emergency department with New York Heart Association class IV heart failure. His electrocardiogram showed sinus rhythm with right bundle branch block and left anterior hemiblock, while echocardiography revealed left ventricular dilation with impaired systolic function (estimated ejection fraction of 30%) and apical, posterior and inferior wall akinesia. Invasive coronary angiography was performed (Fig.  1a, b and online video 1a, 1b).
What is the diagnosis?


You will find the answer elsewhere in this issue.

Conflict of interest

N. Papakonstantinou, N. Miaris, K. Argyrakis, S. Mitsiadis, A. Dimopoulos, G. Gavrielatos, N. Patsourakos, N. Kasinos, A. Theodosis-Georgilas and E. Pisimisis declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Extra materiaal
A fistula arising from the left main coronary artery is revealed.
Video 1b. Left anterior oblique (LAO) caudal view of invasive coronary angiography.
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