title: Bilateral congenital coronary ostial obstruction: Exertional syncope in an otherwise healthy 8-year-old.
abstract: Congenital stenosis/atresia of a coronary artery is an exquisitely rare anomaly (Congenit Heart Dis, 2, 2007, 347) with increased risk of sudden death. Bilateral coronary obstruction is even more unusual but has been reported in conjunction with aortic valve disease, syphilis, and Takayasu's arteritis. To the best of our knowledge, obstruction of both coronaries in a pediatric patient has only been reported once (Ann Thorac Surg, 55, 1993, 1564). We present a patient with an intramural, anomalous aortic origin of the right coronary artery from the contralateral sinus (AAORCA) with near atresia of the left main coronary ostium. The diagnosis was made by echocardiogram and confirmed by catheterization and magnetic resonance imaging.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Medical Center, UT Southwestern Medical Center at Dallas, Dallas, Texas.
authors.forename: Kavita
authors.initials: K
authors.lastname: Sharma
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Medical Center, UT Southwestern Medical Center at Dallas, Dallas, Texas.
authors.forename: Poonam
authors.initials: P
authors.lastname: Thankavel
mesh_terms: D002648:Child; D017023:Coronary Angiography; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D013575:Syncope / Q000175:diagnosis / Q000209:etiology*
keywords: anomalous coronary arteries