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Anomalous Coronary Artery: Run of a Lifetime
Journal article   Peer reviewed

Anomalous Coronary Artery: Run of a Lifetime

Michael Stuart Green, Sankalp Sehgal, Naomi Smukler, LaDouglas Jarod Suber and Pooven Saththasivam
Seminars in cardiothoracic and vascular anesthesia, v 20(3), pp 232-236
Sep 2016
PMID: 26359348

Abstract

Adult Coronary Vessel Anomalies - diagnostic imaging Coronary Vessel Anomalies - surgery Echocardiography, Transesophageal Female Humans Percutaneous Coronary Intervention
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.

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Anesthesiology
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