[Clinical significance of aberrant coronary artery--origin from the aorta (author's transl)].
It is demonstrated the unusual case of a 14-year-old boy, dying suddenly after physical stress with myocardial infarction. Autoptically it was found a coronary artery anomaly of the "malign type" and in addition a significant narrowing of the left main coronary artery. There are presented until now in the literature 17 cases of sudden death in young patients (up to 22 years) in connection with the "malign coronary artery anomaly origin" of both coronary arteries from the right coronary sinus and course of the left coronary artery between the truncus of pulmonary artery and aorta. All 17 cases of sudden death were male. No explanation of the predominance of the male sex is known. Always physical stress preceded the fatal event. Obviously all other abnormalities of coronary artery origin of the aorta and course--except the Bland-White-Garland Syndrome--are of minor clinical importance. In the course of life all coronary vessel anomalies can be accompanied by atherosclerotic processes, followed by clinical symptoms of coronary artery disease. The additional speciality of the demonstrated case is the significant stenosis (75%) in the abnormal course of the main coronary artery. Practical consequence of the presented case is: Even in young patients and children one must be aware of the possibility of a myocardial infarction with coronary artery abnormality if clinical symptoms are present. There may be diagnostic (coronary arteriography) and therapeutic (coronary artery surgery) consequences, if the patient survives the life-threatening event.
D000293:Adolescent; D001011:Aorta / Q000002:abnormalities; D003330:Coronary Vessel Anomalies / Q000503:physiopathology*; D006801:Humans; D008297:Male
Klinische Wertigkeit von Koronargefässanomalien Myokardischämie und plötzlicher Tod in jugendlichem Alter.