CTICasesRCA Sinoatrial Nodal Branch Fistula Draining to Right Atrium
[...]. RCA Sinoatrial Nodal Branch Fistula Draining to Right Atrium. CTICases. Published August 28, 2016. https://str-case-explorer.pages.dev/c/44bjb
Imaging findings
Cardiac MRI shows a mass-like artifact in the right atrium with abnormal, two-directional flow on phase contrast imaging. Further investigation reveals a large, very abnormal proximal right coronary artery (RCA) with a huge vessel branching off, winding around, and draining into the right atrium. This large RCA sinoatrial nodal branch fistula causes the mass-like artifact and right heart enlargement, including an enlarged right atrium. Pulmonary veins drain normally.
Key takeaways
Large coronary artery fistulas, such as a sinoatrial nodal branch fistula from the RCA to the right atrium, can cause significant flow-related artifacts on cardiac MRI that may be mistaken for a mass. These fistulas can lead to right heart enlargement and present with symptoms like shortness of breath. Anomalous pulmonary vein may be an initial misdiagnosis on echo due to abnormal flow near the SVC/RA junction.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- TAVI Leaflet ThrombusValvular
- Kawasaki Disease with Coronary Aneurysms and OcclusionsCoronary
- Pulmonary Microemboli with Right Heart StrainVascular
- Fibrotic NSIP with Organizing Pneumonia in SclerodermaILD
- Organizing Pneumonia Progressing to Fibrosis in Rheumatoid ArthritisILD
- Bicuspid Pulmonic Valve with Main Pulmonary Artery EnlargementValvular
- Aspirated Foreign Body (Almond) Causing Left Lung AtelectasisTrauma
- Milk of Calcium in the Pleural SpaceMetabolic
See all cases from August 28, 2016 →
Related Coronary cases
- Diffuse Coronary Artery Ectasia of Unclear Etiology
- Subendocardial Perfusion Defects with Normal Contractility and Discrepant Angiography (Possible Syndrome X)
- Atherosclerotic Right Coronary Artery Aneurysm
- Anomalous Coronary Artery with Left Ventricular Noncompaction
- Delayed Presentation of Myocardial Infarction with Left Ventricular Thrombus and Dressler's Syndrome
- Coronary Artery Aneurysms in Ulcerative Colitis