Question 898
{"accessible":false,"alternatives":[{"id":4517,"text":"complications include congestive heart failure and coronary artery aneurysm"},{"id":4518,"text":"patients may have a continuous cardiac murmur heard on clinical examination"},{"id":4519,"text":"the most common drainage sites of the fistula are in the left side of the heart"},{"id":4520,"text":"the most common origins of the fistula are the RCA and LAD"},{"id":4521,"text":"they are most commonly congenital in etiology but can also be acquired"}],"archived":false,"correctAlternativeId":4519,"explanation":"\u003cp\u003e\u003ca href=\"/articles/coronary-arteriovenous-fistula\"\u003eCoronary arteriovenous fistulas\u003c/a\u003e (CAVFs)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eare rare\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/congenital-coronary-artery-anomalies\"\u003ecoronary artery anomalies\u003c/a\u003e\u0026nbsp;whereby there is a fistula between a\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/coronary-arteries\"\u003ecoronary artery\u003c/a\u003e\u0026nbsp;and, most commonly, the right side of the cardiac circulation. Usually congenital in etiology, the most common origins for the CAVF are the\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/right-coronary-artery\"\u003eRCA\u003c/a\u003e\u0026nbsp;(50%) and\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/left-anterior-descending-artery\"\u003eLAD\u003c/a\u003e\u0026nbsp;(42%) while the most common drainage sites are the relatively low-pressure\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/right-ventricle\"\u003eright ventricle\u003c/a\u003e\u0026nbsp;(41%),\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/right-atrium\"\u003eright atrium\u003c/a\u003e\u0026nbsp;(26%), or\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/pulmonary-trunk\"\u003epulmonary artery\u003c/a\u003e\u0026nbsp;(17%).\u003c/p\u003e\u003cp\u003ePatients are often asymptomatic, but may have exertional dyspnea and angina, and may have a continuous cardiac murmur. Radiographically, coronary artery angiographically and CT provide the best demonstration of\u0026nbsp;the origin, drainage, size, and course of CAVFs. Symptomatic patients can be managed\u0026nbsp;via either transcatheter embolization or surgical ligation.\u003c/p\u003e\u003cp\u003eCommon complications of untreated CAVFs include\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/pulmonary-hypertension-1\"\u003epulmonary hypertension\u003c/a\u003e,\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/congestive-cardiac-failure\"\u003econgestive heart failure\u003c/a\u003e,\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/coronary-artery-aneurysm\"\u003ecoronary artery aneurysm\u003c/a\u003e,\u0026nbsp;coronary artery or fistula rupture causing\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/cardiac-tamponade\"\u003ecardiac tamponade\u003c/a\u003e,\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/infective-endocarditis\"\u003ebacterial infective endocarditis\u003c/a\u003e, and\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/myocardial-infarction\"\u003eacute myocardial infarction\u003c/a\u003e\u0026nbsp;due to fistula thrombosis.\u003c/p\u003e","id":898,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/898","nextQuestionPath":null,"relatedArticles":[{"id":55515,"title":"Coronary arteriovenous fistula","link":"/articles/coronary-arteriovenous-fistula?lang=us"},{"id":37916,"title":"Coronary artery aneurysm","link":"/articles/coronary-artery-aneurysm?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eWhich of the following is\u0026nbsp;\u003cstrong\u003eNOT\u003c/strong\u003e\u0026nbsp;true of coronary arteriovenous fistulas?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/898"}],"attemptsPercentages":[{"alternativeId":"4519","percentage":60},{"alternativeId":"4518","percentage":7},{"alternativeId":"4520","percentage":13},{"alternativeId":"4521","percentage":15},{"alternativeId":"4517","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"congenital-coronary-artery-anomalies"}