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Given the consistency of the clinical profile with typical angina, associated risk factors, and abnormal ECG findings, a cardiology consult was promptly requested. Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates.
Patient underwent surgical closure of fistula and a 2-vessel coronary artery bypass graft surgery, with a LIMA pedicle graft to the LAD, and SV graft to the LCx.Postoperatively, patient was continued on medical therapy with improvement of symptoms. CCF can be congenital or acquired and has many variations. It is often clinically silent.
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