Key result
Conventional non-invasive testing fails to detect anomalous coronary origin preceding sudden cardiac death in athlete.
Why the study?
Anomalous coronary origin is a preventable cause of sudden cardiac death in young athletes, but its diagnosis is usually missed by conventional non-invasive investigations designed to identify myocardial ischaemia.
Case Report (n=1)
Highlights that anomalous coronary origin in young athletes presenting with prodromal symptoms is frequently missed by conventional non-invasive myocardial ischemia testing, leading to preventable sudden cardiac death.
Answers are grounded in this paper and cite their sources.
Negative conventional tests may miss anomalous coronary origins in symptomatic athletes; leaves open optimal diagnostic strategies.
The sudden cardiac death (SCD) of a young athlete is a catastrophic event, particularly in the absence of prodromal warning symptoms. Anomalous coronary origin (ACO) is a well-described cause of cardiac symptoms and SCD, but the diagnosis is usually missed by conventional non-invasive investigations designed to identify myocardial ischaemia. SCD is preventable by correction of the anomaly. A tragic case of a promising young athlete who had underlying ACO and who presented with prodromal symptoms with multiple "negative" investigations is described to highlight the typical clinical features and outline the difficulties encountered in accurate premortem diagnosis.
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Edwards et al. (2010) conducted a case report in Anomalous coronary origin (n=1). Conventional non-invasive investigations for myocardial ischaemia was evaluated on Premortem diagnosis of anomalous coronary origin and prevention of sudden cardiac death. Anomalous coronary origin caused sudden cardiac death in 1 young athlete despite prodromal symptoms and multiple negative conventional non-invasive investigations.
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