title: Anomalous Coronary Artery: Run of a Lifetime.
abstract: 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.
authors.affiliation: Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA michael.green@drexelmed.edu.
authors.forename: Michael Stuart
authors.initials: MS
authors.lastname: Green
authors.affiliation: Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA.
authors.forename: Sankalp
authors.initials: S
authors.lastname: Sehgal
authors.affiliation: Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA.
authors.forename: Naomi
authors.initials: N
authors.lastname: Smukler
authors.affiliation: Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA.
authors.forename: LaDouglas Jarod
authors.initials: LJ
authors.lastname: Suber
authors.affiliation: Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA.
authors.forename: Pooven
authors.initials: P
authors.lastname: Saththasivam
mesh_terms: D000328:Adult; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D062645:Percutaneous Coronary Intervention
keywords: coronary angiography; coronary artery bypass; coronary vessels; echocardiography; transesophageal