Spontaneous Regression Of Coronary Artery Fistula In 5q-syndrome
Nishikawa, T., Higaki, A., Hosokawa, T., Miyabe, R., Fujisawa, T., Miyazaki, S., Akazawa, Y., Miyoshi, T., Kawakami, H., Seike, F., Higashi, H., Tamaki, S., Nishimura, K., Inoue, K., Ikeda, S., & Yamaguchi, O. (2024). Spontaneous Regression of Coronary Artery Fistula in 5q-Syndrome. Circulation journal : official journal of the Japanese Circulation Society, 88(9), 1500. https://doi.org/10.1253/circj.CJ-24-0306
View Original Source →Case Details
Disease Location
Heart (coronary fistula)
Personal Characteristics
73-year-old woman, history of gastric cancer
Clinical Characteristics
During preoperative assessment for gastric cancer, an asymptomatic coronary artery fistula was discovered. Myocardial computed tomography perfusion imaging revealed reduced myocardial blood flow in the left anterior descending artery region. Angiography showed that the fistula originated from the proximal lad and connected to the pulmonary artery. A year later, she was diagnosed with autoimmune hemolytic anemia (aiha) coexisting with 5q−syndrome. Corticosteroid therapy, lenalidomide 5mg daily and blood transfusions were initiated.
Remission Characteristics
Coronary CT angiography performed 4 years after her initial visit, the known caf was not identified, and ischemia in the lad region had disappeared on perfusion CT.
Treatment & Mechanisms
Proposed Remission Mechanisms
Anti-angiogenic properties of lenalidomide
Clinical Treatment
Corticosteroid, lenalidomide, blood transfusions