Key result
Single coronary ostium below an aortic valve leaflet is linked to sudden death despite unobstructed pathways.
Why the study?
Congenital coronary anomalies are rare causes of serious cardiovascular events including sudden death in both young and old, highlighting the need to recognize them and evaluate their role in unexplained deaths.
Congenital coronary anomalies should be considered as a potential cause of sudden and unexplained death, even in elderly patients.
Congenital anomalies warrant consideration in elderly sudden unexplained death; extends prior associations to older patients.
Congenital coronary anomalies are rare but can cause serious cardiovascular events, including sudden death, in both young and old. A forensic autopsy of a 67-year-old woman found dead at her home revealed a single low coronary ostium located under an aortic valve leaflet, with an unobstructed coronary pathway. Myocardial scarring from a previous infarction was identified in the interventricular septum. This case illustrates the importance of recognising congenital coronary anomalies, even in elderly people, and evaluating their possible role in a sudden and unexplained deaths. A review of the literature of congenital coronary anomalies is provided to put this case into context.
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Aarab et al. (2026) studied this question. A single coronary ostium located below an aortic valve leaflet can be associated with sudden death even with unobstructed pathways, evident in a 67-year-old autopsy case.
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