Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Tex Heart Inst J. 2015 Dec 1;42(6):554-7. doi: 10.14503/THIJ-14-4249. eCollection 2015 Dec.

Abstract

Anomalous origin of the left main coronary artery from the right sinus of Valsalva is extremely rare and can lead to sudden cardiac death. We report a case in which an 18-year-old college student collapsed immediately after a long-distance run of 10 km. After cardiopulmonary resuscitation and electrical shock for ventricular fibrillation, she experienced a return of spontaneous circulation. Cardiac catheterization and cardiac computed tomographic angiography revealed an unusually long intramural course of the left main coronary artery from the right sinus of Valsalva. The young woman underwent a successful unroofing operation for coronary artery correction. She remained asymptomatic upon exercise during 2.5 years of follow-up.

Keywords: Coronary vessel anomalies/radiography/surgery; death, sudden, cardiac/pathology; exercise, strenuous; heart defects, congenital; left main coronary artery/abnormalities; sinus of Valsalva/abnormalities; sports.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cardiac Catheterization
  • Cardiac Surgical Procedures
  • Cardiopulmonary Resuscitation
  • Coronary Angiography / methods
  • Coronary Vessel Anomalies / complications*
  • Coronary Vessel Anomalies / diagnosis
  • Coronary Vessel Anomalies / surgery
  • Death, Sudden, Cardiac / etiology*
  • Death, Sudden, Cardiac / prevention & control
  • Electric Countershock
  • Electrocardiography
  • Female
  • Humans
  • Multidetector Computed Tomography
  • Out-of-Hospital Cardiac Arrest / diagnosis
  • Out-of-Hospital Cardiac Arrest / etiology*
  • Out-of-Hospital Cardiac Arrest / therapy
  • Recovery of Function
  • Running*
  • Sinus of Valsalva / abnormalities*
  • Sinus of Valsalva / diagnostic imaging
  • Sinus of Valsalva / surgery
  • Treatment Outcome