A Case for Routine Screening of Coronary Artery Origins During Echocardiography: Fortuitous Discovery of a Life-Threatening Coronary Anomaly

Management of anomalous coronary arteries from the contralateral sinus

“…Coronary artery bypass grafting, employing both saphenous vein and internal mammary artery grafts, has been successful in ameliorating symptoms [7,43] and eliminating ischemia [6,7,43,44]. Some surgeons will only offer bypass if there is proximal disease of the anomalous vessel, because internal mammary grafts have thrombosed secondary to competitive flow [45].…”

Syncope in a child owing to intramural course of the left coronary artery

“…Some reports are found in the cardiological literature (5,7), others are dispersed in journals of pathology or forensic medicine (4), since sudden unexpected death can be the first manifestation of some of the various anomalies. Among the manifold coronary anomalies, the origin of the left coronary artery from the right coronary sinus is a well-defined malformation (1).…”

“…Very few articles refer to symptomatic patients who were diagnosed during life (5)(6)(7). Thus, articles are dispersed throughout the cardiological (5,7) and forensic medical literature (4). We report on a 14-y-old girl whose history is unusual and impressive because of its long duration, its characteristic symptoms and differential diagnostic pitfalls.…”

“…Most reports are from sudden death autopsy cases (2)(3)(4). Very few articles refer to symptomatic patients who were diagnosed during life (5)(6)(7). Thus, articles are dispersed throughout the cardiological (5,7) and forensic medical literature (4).…”

Echocardiography and Coronary CT Angiography Imaging of Variations in Coronary Anatomy and Coronary Abnormalities in Athletic Children: Detection of Coronary Abnormalities that Create a Risk for Sudden Death

“…By contrast, others with this condition may be completely asymptomatic . The variability of the clinical presentation is not clearly understood . However, the presence of symptoms provides an opportunity for early identification by careful attention to the coronary origins when scanning the aortic sinuses.…”