Congenital descending aorta to pulmonary vein fistula: an unusual cause of left ventricular dilation in a 21-year-old female.

BACKGROUND: Congenital descending aorta to pulmonary vein fistula (cDAPVF) is a rare congenital vascular malformation diagnosed in infancy and childhood. Adult cDAPVF is often asymptomatic and usually detected incidentally by imaging. At present, cases of adults with an enlarged left heart due to cDAPVF have rarely been reported. CASE PRESENTATION: We reported a case of 21-year-old female who presented with an unexplained continuousmurmur and left ventricular enlargement followed up for 6 years. The patient developed chest tightness five days ago. The patient was diagnosed with cDAPVF, as revealed by echocardiography combined with computed tomography angiography (CTA). The patient underwent arteriovenous embolization, with satisfactory improvement in symptoms and left ventricular size during follow-up examinations. CONCLUSIONS: cDAPVF should be considered in patients with unexplainable left ventricular continuous murmur. CTA serves as a valuable adjunct for diagnosing abnormal vascular connections that cannot be identified by Doppler echocardiography. Transcatheter embolization may be an effective treatment for cDAPVF.