Abstract
A 41-year old woman presented at the emergency department because of collapse during running. Coronary computed tomography angiography (CTA) showed no atherosclerosis (Fig. 1). However, as demonstrated by the double oblique view of the sinus of Valsalva in Panel A and 3D-rendering of Panel B, the left coronary artery (LCA) originated from the right coronary sinus. The LCA has an acute angle and a ‘slitlike’ ostium which can collapse in a valve-like manner during exercise. The incidence of this finding on CTA ranges from 0.7– 6.6 % [1, 2]. Adenosine stress CT myocardial perfusion imaging (CTP) was performed. Panel C demonstrates a sub-endocardial perfusion defect in the LCA region (white arrows). Panel D represents the polar map of the transmural perfusion ratio. Surgical unroofing was performed successfully and no further events have occurred [3]. In patients presenting with collapse a malignant coronary anomaly can be observed. CTP can subsequently be performed to detect myocardial ischaemia. Fig. 1 Computed tomography coronary angiography and myocardial perfusion imaging
Highlights
Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users
Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course: case report and review of the literature
Summary
Electronic supplementary material The online version of this article (doi:10.1007/s12471-015-0788-0) contains supplementary material, which is available to authorized users. A.J. Scholte ( ) · M.A. de Graaf · A.R. van Rosendael · H.W. Vliegen · J.J. Bax Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands e-mail: m.a.de_graaf@lumc.nl
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