title: Exercise-induced myocardial ischemia in a case of anomalous origin of the left main coronary artery from the noncoronary sinus of valsalva.
abstract: We report a case of anomalous origin of the left main coronary artery (LCA) from the noncoronary sinus of valsalva (LCANCS) in a young healthy patient who presented with syncope and cardiopulmonary arrest during exercise. The enhanced computed tomography showed acute angle take-off (AAT) of LCA, and the exercise stress thallium-201 myocardial scintigraphy demonstrated a large defect at the LCA perfusion region. We propose that the coexistence of AAT and resulting ischemia causes sudden cardiac death during exercise in the patients with LCANCS.
authors.affiliation: Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. mnishiyama.ped@tmd.ac.jp
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Nishiyama
authors.forename: Shouzaburo
authors.initials: S
authors.lastname: Doi
authors.forename: Akiko
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Masato
authors.initials: M
authors.lastname: Nishioka
authors.forename: Susumu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Akihito
authors.initials: A
authors.lastname: Sasaki
authors.forename: Shuki
authors.initials: S
authors.lastname: Mizutani
mesh_terms: D000293:Adolescent; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D025401:Echocardiography, Stress; D004562:Electrocardiography; D015444:Exercise; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging; D012850:Sinus of Valsalva / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D016277:Ventricular Function, Left