Intramural Course of the Left Main Coronary Artery
Abstract
Malignant or interarterial course of the large epicardial coronary arteries can cause myocardial ischemia, angina, acute coronary syndromes, congestive heart failure, or sudden cardiac death. Interarterial course occurs when the coronary artery originates from the inappropriate sinus. We describe a case of an 18-year-old healthy collegiate basketball player who presented with ventricular fibrillation and cardiogenic shock due to an interarterial and intramural course of an anomalous left coronary artery without an ectopic origin.
References
1. Maron BJ. Sudden death in young athletes. N Engl J Med. 2003 Sep 11; 349(11): 1064-1075. doi: 10.1056/NEJMra022783
2. Maron BJ, Doerer JJ, Haas TS, et al. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009; 119(8): 1085-1092.
3. Reul RM, Cooley DA, Hallman GL, Reul GJ. Surgical treatment of coronary artery anomalies: report of a 37 1/2-year experience at the Texas Heart Institute. Tex Heart Inst J. 2002; 29(4): 299-307.
4. Lim JC, Beale A, Ramcharitar S. Anomalous origination of a coronary artery from the opposite sinus. Nat Rev Cardiol. 2011 Oct 11; 8(12): 706-719. doi: 10.1038/nrcardio.2011.147.
5. Angelini P, Walmsley R, Cheong BY, Ott DA. Left main coronary artery originating from the proper sinus but with acute angulation and an intramural course, leading to critical stenosis. Tex Heart Inst J. 2010; 37(2): 221-225.
6. Brothers JA, Frommelt MA, Jaquiss RDB, et al. Expert consensus guidelines: Anomalous aortic origin of a coronary artery. J Thorac Cardiovasc Surg. 2017 Jun; 153(6): 1440-1457. doi: 10.1016/j.jtcvs.2016.06.066
