Multimodality Assessment of Anomalous Aortic Origin of the Right Coronary Artery Presenting With Cardiac Arrest

Abstract

Anomalous aortic origin of coronary artery (AAOCA) can range from benign anatomic variants to those presenting with sudden cardiac arrest. This unique case of right AAOCA demonstrates detailed anatomic findings from cardiac computed tomography and the effects of transient acute coronary ischemia by cardiac magnetic resonance. ( Level of Difficulty: Advanced. )

How to Work Up a Case of Sudden Cardiac Arrest in a Young Sportsman

“…In a patient with R-ACAOS-IM and ventricular arrhythmia, like that reported by de Oliveira Nunes et al. ( 4 ), maximal exertion testing could be life-saving by discovering episodes of ventricular arrhythmia potentially related to right ventricular arrhythmogenic cardiomyopathy.…”

“…The case reported by De Olivera Nunes et al. ( 4 ) is quite rare, and the accompanying clinical features are important to review. First, no pre-event symptoms were reported ( 4 ).…”

“…( 4 ) is quite rare, and the accompanying clinical features are important to review. First, no pre-event symptoms were reported ( 4 ). Not mentioned is whether the young man was pre-certified for sports participation; in any case, his medical history plus a physical examination (the standard pre-participation screening technique in the United States) usually could not identify ACAOS, as confirmed by this reviewer's large cardiac magnetic resonance (CMR) imaging-based screening study in students 11 to 18 years of age ( 10 , 11 ).…”

“…The paper by De Olivera Nunes et al. ( 4 ) in this issue of JACC: Case Reports offers an occasion to consider updated rules for this evolving discipline in sports cardiology. The case report describes a 14-year-old boy who experienced sudden cardiac arrest (SCA) during customary exercise without ever having reported any relevant symptoms.…”