Yonsei Med J.  2011 Sep;52(5):856-858. 10.3349/ymj.2011.52.5.856.

Unexpected Sudden Death of a 19-Year-Old Female with Congenital Single Coronary Artery Ostium during Exertion

• Won YJ
• Kim HJ
• Lee H

• KMID: 1108081
• DOI: http://doi.org/10.3349/ymj.2011.52.5.856

Abstract

Coronary artery anomalies are associated often with myocardial ischemia or sudden cardiac death. A 19-year-old woman who participated in an exertive game lost consciousness upon one such exertion. She was taken to a hospital where she died on the same day. An autopsy revealed that she had bifurcated coronary arteries, which arose from one coronary ostium in the left sinus of Valsalva. The right coronary artery arose from the left sinus and traveled between the aorta and the pulmonary trunk. The heart as well as the cardiac conduction system depended exclusively on the single coronary artery ostium for oxygenated blood supply, and the unbalanced blood distribution on her exertion probably led to sudden cardiac death. The case highlights the medicolegal importance of unexpected sudden cardiac death related to an anomalous origin of the coronary arteries.

Keyword

Exertion; sudden death; congenital single coronary artery

MeSH Terms

Autopsy
Coronary Vessel Anomalies/*complications/pathology
Coronary Vessels/pathology
Death, Sudden, Cardiac/*etiology/pathology
Female
Humans
Physical Exertion
Sinus of Valsalva/abnormalities
Young Adult

Figure

• 

  Fig. 1 Internal view of the aortic sinuses shows the single coronary artery ostium (arrow) arising from the left aortic sinus of Valsalva.

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  Fig. 2 Projectional diagrams of the base of the heart illustrating basic anatomical distribution patterns. (A) normal pattern, (B) single left coronary artery ostium, (C) single right coronary artery ostium. P.A., pulmonary artery; L. Circ., left circumflex coronary artery; LAD, left anterior descending coronary artery; R. Cor., right coronary artery.

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