Keywords: Congenital heart disease; coronary arterial anomalies; atresia of coronary arteries C ONGENITAL ANOMALIES OF THE CORONARY ARTERIES are rare. Patients can be asymptomatic, or may present with overt myocardial ischaemia and sudden cardiac death. Early diagnosis, with timely intervention, often, however, ensures good long-term outcome. We present angiographic images of an adolescent patient with one such anomaly.A 13-year-old male was admitted for acute pulmonary oedema following exertion at a football game. Previous history of breathlessness during sporting activity was attributed to malingering. High levels of creatine phosphokinase and elevation of the ST segment in the anterior leads were noted. Echocardiography revealed an ejection fraction of 30%. Coronary angiography was performed after stabilization with inotropic and ventilatory support. The left anterior oblique view (Fig. 1) revealed a normally located orifice of the main stem of the left Figure 1.Figure 2.
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