This case report describes a novel and extremely rare congenital coronary anomaly—both LCA and RCA originating from the posterior sinus—as a cause of sudden cardiac death in a young athlete.
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Alerts clinicians to rare posterior sinus coronary origins in young athlete SCD; extends anatomic variants but remains hypothesis-generating.
Congenital anomalies of the coronary arteries are relatively uncommon conditions and have been associated with sudden cardiac death (SCD) in children. Although anomalous coronary artery distribution is widely reported in the literature, no articles to date address the origin of both the right (RCA) and left coronary arteries (LCA) from the posterior (noncoronary) sinus of Valsalva. This is a report of a 16-year-old black male in good health, who collapsed and was unable to be resuscitated after physical exertion while playing basketball. In this patient, postmortem evaluation revealed the LCA and RCA originating exclusively from the posterior (noncoronary) sinus with acute angle takeoff of the LCA which likely lead to ischemia, causing SCD. We discuss the incidence of coronary artery anomalies and the proposed mechanisms that led to SCD in these patients.
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Catanzaro et al. (2005) studied this question.
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