Anomalous origin of the left coronary artery leading to myocardial infarction in a 14-year-old boy

Abstract

An anomalous origin of the coronary artery is an infrequent but significant cause of myocardial ischemia and sudden death. A left coronary artery arising from the right sinus of Valsalva is of clinical value due to its possible association with sudden cardiac death, particularly when it courses between the aorta and pulmonary trunks. Nevertheless, it is amenable to appropriate surgical intervention, thereby emphasizing the importance of clinical suspicion and timely identification. We report the case of a 14-year-old boy, who presented with acute myocardial infarction of the anterior wall, with an anomalous left coronary artery originating from the right sinus of Valsalva. Transthoracic echocardiographic evaluations of the anomalous origin of the coronary artery and Doppler finding of a 'finger-tip phenomenon', which can be observed under circumstances of myocardial bridging, allowed the diagnosis of this anomaly. © 2007, The Korean Society of Circulation.