Aborted sudden cardiac death associated with an anomalous right coronary artery

Abstract

SUMMARYCoronary artery anomalies arising from the opposite sinus of Valsalva and having an interarterial course between the aorta (AO) and pulmonary artery (PA) are the second most common cause of sudden cardiac death among young athletes, after hypertrophic cardiomyopathy. The right coronary artery (RCA) originating from the AO above the left sinus of Valsalva (LSV) is an extremely rare anomaly. We report the first case of a RCA arising from the AO above the LSV that subsequently runs between the AO and the PA, discovered by a 64-slice multidetector coronary CT, in a patient who was successfully resuscitated from ventricular fibrillation (VF) cardiac arrest while running in a marathon race. BACKGROUND

Exercise-Induced Ischemic ST-Segment Elevation in Anomalous Origin of the Right Coronary Artery From the Left Sinus of Valsalva With an Intramural Course and Blocked Coronary Bypass

“…Similarly, one autopsy study showed that 38-66% of ACAOS cases were asymptomatic before death and 75-83% died during exercise [ 6 ]. Previous case reports suggested that SCEs in young runners can be attributed to R-ACAOS-IM [ 7 , 8 ]. Typical acute waveforms of ischemic events in R-ACAOS-IM patients are indicated as ST-segment elevations of up to 0.2 mV in leads II, III, and aVF, and subsequent waveforms as normalized ST-segment elevations and negative T-waves in leads II, III, and aVF [ 7 ].…”

Left Atrial Myxoma Associated with Malignant Anomalous Course of Right Coronary Artery: A Rare Concurrent Incidence of Two Rare Diseases

“…Coronary artery anomalies arising from the opposite sinus of Valsalva are the second most common cause of sudden cardiac death among young athletes after hypertrophic cardiomyopathy [6].…”

Valor de la angiografía coronaria por tomografía computarizadaen el diagnóstico de las anomalías coronarias

“…En la actualidad, la ACTC es una técnica de diagnóstico eficaz e ideal para la evaluación de pacientes jóvenes con sintomatología cardiaca y alta sospecha de una AC 10,30 . En este estudio, la paciente 5 que sufrió un colapso cardiovascular por una fibrilación ventricular mientras participaba en una maratón, había comenzado a presentar disnea de esfuerzo dos meses antes del evento.…”

“…Su evaluación cardiológica incluyó un ecocardiograma bidimensional y un test de esfuerzo que fueron normales. Sin embargo, el diagnóstico pudo haberse hecho si una ACTC hubiese sido realizada 29,30 . La ACTC es un complemento indispensable para aquellos pacientes cuyo diagnóstico inicial se ha hecho mediante ACI, en los que no fue posible determinar el trayecto del vaso anómalo.…”