Takefumi Oka, MD; Takaaki Nakatsu, MD; Shozo Kusachi, MD; Youkou Tominaga MD; Shinji Toyonaga MD; Kenzo Hori, MD

Abstract
A 54-year-old woman was admitted to our hospital because of a heart murmur without subjective symptoms. Angiography disclosed an enlarged right coronary artery and flow drainage into the left ventricle, ie, a large right coronary artery-left ventricle fistula. Analysis of pulsed Doppler studies and cineangiograms indicated considerable capacitance of this fistula owing to Windkessel action, which attenuated volume overload on the left ventricle. The features in this case suggest that evaluation of fistula hemodynamics is important in determining the overload on the ventricle through the fistula.
(Jpn Circ J 1997; 61: 719-723)

Key Words: Echocardiography; Hemodynamics; Coronary artery anomaly; Flow velocity

Mailing address: Takaaki Nakatsu, MD, Department of Cardiovascular Medicine, Yashima General Hospital, Nishimachi 1857-1, Yashima, Takamatsu 761-01, Kagawa 761-01, Japan