Aortocaval fistula mimicking an acute coronary syndrome

Carlo Vigna, Tiberio Santoro, Antonio Facciorusso, Giovanni Paroni, Raffaele Fanelli

Research output: Contribution to journalArticlepeer-review


A 75-year-old man complained of episodes of chest pain and dyspnea. An acute coronary syndrome was suspected but coronary angiography showed only mild stenosis (less than 50% reduction of vessel diameter) of the left anterior descending artery. We performed an aortography that showed a large infrarenal aneurysm with direct communication from the aorta to the inferior vena cava, forming an aortocaval fistula (ACF). The patient was immediately brought to the operating room where he underwent a successful surgical repair. The interesting aspect of our case is the clinical presentation mimicking an acute coronary syndrome with shock and bradyarrhythmias. The prompt diagnosis of ACF is very difficult because this rare pathology may present with several signs and symptoms. Surgery, or endovascular treatment in selected cases, is the only chance of survival.

Original languageEnglish
Pages (from-to)1138-1139
Number of pages2
JournalJournal of Cardiovascular Medicine
Issue number11
Publication statusPublished - Nov 2008


  • Acute coronary syndrome
  • Aortocaval fistula

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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