Anomalous Coronary Artery Run of a Lifetime

The anatomy of the coronary circulation is well described with incidence of congenital anomalies of approximately 0.3% to 1.0%. Although often incidental, 20% are life-threatening. A 25-year-old woman with syncopal episodes collapsed following a 10-km run. Coronary anatomy evaluation showed an anoma...

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Bibliographic Details
Published in:	Seminars in cardiothoracic and vascular anesthesia Vol. 20; no. 3; pp. 232 - 236
Main Authors:	Green, Michael Stuart, Sehgal, Sankalp, Smukler, Naomi, Suber, LaDouglas Jarod, Saththasivam, Pooven
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-09-2016
Subjects:	Adult Coronary Vessel Anomalies - diagnostic imaging Coronary Vessel Anomalies - surgery Echocardiography, Transesophageal Female Humans Percutaneous Coronary Intervention transesophageal coronary vessels coronary artery bypass coronary angiography echocardiography
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Summary:	The anatomy of the coronary circulation is well described with incidence of congenital anomalies of approximately 0.3% to 1.0%. Although often incidental, 20% are life-threatening. A 25-year-old woman with syncopal episodes collapsed following a 10-km run. Coronary anatomy evaluation showed an anomalous left main coronary artery originating from the right sinus of valsalva and following a course between the aorta and the pulmonary outflow tract. Percutaneous coronary intervention was followed by eventual surgical revascularization. Abnormal course of coronary arteries plays a role in the pathogenesis of sudden death on exertion. Origin of the left main coronary from the right sinus of valsalva is a rare congenital anomaly. The expansion of the roots of the aorta and pulmonary trunk with exertion lead to compression of the coronary artery and syncope. Our patient raises awareness of a potentially fatal coronary artery path. Intraoperative identification of anomalous coronaries by utilizing intraoperative transesophageal echocardiography was critical.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	1089-2532 1940-5596
DOI:	10.1177/1089253215605389