J Cardiovasc Ultrasound.  2007 Sep;15(3):94-97.

A Case of Anomalous Origin of the Left Coronary Artery from the Right Coronary Sinus in a 15-year-old Boy Suffered from Exertional Syncope

• Choi JH
• Kim SH
• Kim YC
• Park EM
• Rhee SJ
• Yun KH
• Kim NH
• Oh SK
• Choi JB
• Jeong JW

Abstract

We report a case of an anomalous origin of the left coronary artery from the right aortic sinus in young boy with exertional syncope. A 15-year-old boy was admitted to the hospital because of severe retrosternal chest pain followed by syncope during exertion. He had a similar history of syncope during exercise previously. On site transthoracic echocardiography showed that abnormal color mosaics course between aorta and pulmonary artery, suggesting the anomalous left coronary artery originated from the right aortic sinus, and the definite diagnosis was made by multidetector computed tomography (MDCT) thereafter. Coronary angiography showed anomalous origin of the left main coronary artery (LMCA) from the right coronary sinus. The right coronary artery was normal. Mid portion of the LMCA was angulated and narrowed significantly. Surgical correction of the left coronary artery by reimplantation of the ostium to the left aortic sinus and augmentation of the ostium using oval vein patch was performed successfully.

Keyword

Anomalous origin of coronary artery; Echocardiography; Syncope; Multidetector computed tomography; Coronary vessel anomaly

MeSH Terms

Adolescent*
Aorta
Chest Pain
Coronary Angiography
Coronary Sinus*
Coronary Vessel Anomalies
Coronary Vessels*
Diagnosis
Echocardiography
Humans
Male*
Multidetector Computed Tomography
Pulmonary Artery
Replantation
Sinus of Valsalva
Syncope*
Veins