EURORAD ESR

Case 15239

Unusual cause of abnormal cardiac stress test

Author(s)
Dr. Bossu Nicolas
Prof. Dr. Dymarkowski Steven

UZ LEUVEN , GASTHUISBERG; HERESTRAAT 49 3000 Leuven, Belgium; Email:bossu.nicolas@gmail.com
 
Patient
male, 58 year(s)
 
 
  • Figure 1
    contrast enhanced, ECG-triggered coronary CT scan axial images
     

    Drainage of the vascular fistula in de pulmonary trunk with contrastjet.

     
    Area of Interest: Cardiac; Cardiovascular system; Mediastinum; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Congenital; Fistula;

    Dilated tortuous costobronchial trunk arising from the right side of the descending aorta.

     
    Area of Interest: Cardiac; Cardiovascular system; Mediastinum; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Diagnostic procedure; Special Focus: Congenital; Fistula;

    Collateral vessels cranial of the pulmonary trunk with connection to coronary artery branches (2 branches from RCA and multiple septal branches from the LAD)

     
    Area of Interest: Cardiac; Cardiovascular system; Mediastinum; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Diagnostic procedure; Special Focus: Congenital; Fistula;
     
     
  • Figure 2
    Volume rendering of contrast enhanced, ECG-triggered CT scan
     

    Visualisation of two branches from the right coronary artery supplying the fistula to the pulmonary trunk.

     
    Area of Interest: Cardiac; Cardiovascular system; Mediastinum; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Diagnostic procedure; Special Focus: Congenital; Fistula;

    Visualisation of septal branches from the left descending artery (LAD) supplying the fistula to the pulmonary trunk.

     
    Area of Interest: Cardiac; Cardiovascular system; Mediastinum; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Diagnostic procedure; Special Focus: Congenital; Fistula;

    Parasagittal view of the costobronchial trunk supply of the cardiac fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Parasagittal view of the costobronchial trunk supply of the cardiac fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Parasagittal view of the costobronchial trunk supply of the cardiac fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Parasagittal view of the costobronchial trunk supply of the cardiac fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Anterior view showing the tortuous vessels of the fistula in the "aortopulmonic" window to the pulmonary trunk.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Anterior oblique view showing the tortuous vessels of the fistula in the "aortopulmonic" window to the pulmonary trunk.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Anterior oblique view showing the tortuous vessels of the fistula in the "aortopulmonic" window to the pulmonary trunk.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;
     
     
  • Figure 3
    3D animation movie

    3D animation showing the supplying branches from coronary (RCA and LAD) and costobranchial trunk, draining to the pulmonary trunk.

     
    Area of Interest: Cardiac; Cardiovascular system; Mediastinum; Imaging Technique: CT-Angiography; Procedure: Computer Applications-3D; Special Focus: Congenital; Fistula;
     
     
  • Figure 4
    Maximum intensity projections 10 mm parasagittal plane movie
     

    Maximum intensity projections 10 mm in a paracoronal plane showing the dual coronary supply of the systemic pulmonary fistula as well as the supplying right costobronchial trunk.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm in a parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula as well as the supplying right costobronchial trunk.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;
     
     
  • Figure 5
    Maximum intensity projections 10 mm parasagittal plane images
     

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;

    Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.

     
    Area of Interest: Cardiac; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Fistula;
     
     
Drainage of the vascular fistula in de pulmonary trunk with contrastjet.
 
Dilated tortuous costobronchial trunk arising from the right side of the descending aorta.
 
Collateral vessels cranial of the pulmonary trunk with connection to coronary artery branches (2 branches from RCA and multiple septal branches from the LAD)
 
Visualisation of two branches from the right coronary artery supplying the fistula to the pulmonary trunk.
 
Visualisation of septal branches from the left descending artery (LAD) supplying the fistula to the pulmonary trunk.
 
Parasagittal view of the costobronchial trunk supply of the cardiac fistula.
 
Parasagittal view of the costobronchial trunk supply of the cardiac fistula.
 
Parasagittal view of the costobronchial trunk supply of the cardiac fistula.
 
Parasagittal view of the costobronchial trunk supply of the cardiac fistula.
 
Anterior view showing the tortuous vessels of the fistula in the "aortopulmonic" window to the pulmonary trunk.
 
Anterior oblique view showing the tortuous vessels of the fistula in the "aortopulmonic" window to the pulmonary trunk.
 
Anterior oblique view showing the tortuous vessels of the fistula in the "aortopulmonic" window to the pulmonary trunk.
 
3D animation showing the supplying branches from coronary (RCA and LAD) and costobranchial trunk, draining to the pulmonary trunk.
 
Maximum intensity projections 10 mm in a paracoronal plane showing the dual coronary supply of the systemic pulmonary fistula as well as the supplying right costobronchial trunk.
 
Maximum intensity projections 10 mm in a parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula as well as the supplying right costobronchial trunk.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
Maximum intensity projections 10 mm parasagittal plane showing the dual coronary supply of the systemic pulmonary fistula.
 
 
 
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