Heart Arrest Revealing a Killer Coronary Artery

M. Naaim *

Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.

M. Ztati

Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.

M. El Jamili

Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.

S. El Karimi

Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.

M. El Hattaoui

Cardiology Department, ARRAZI Hospital, Mohammed VI University Hospital, Marrakech, Morocco.

*Author to whom correspondence should be addressed.


Anomalous origin of the left main coronary artery is a congenital heart defect in which it arises from the right coronary sinus. This anomaly carries a high risk of sudden death. The diagnosis can be made by ultrasound examination. Silent myocardial ischemia must be sought. Various surgical techniques have been described. We report the case of a child who presented with cardiac arrest occurring at rest, recovered by external cardiac massage and which has benefited from a surgical intervention with a good evolution.

Keywords: Congenital coronary artery anomalies, interarterial pathway, computed tomography angiography, sudden death

How to Cite

Naaim, M., Ztati, M., Jamili, M. E., Karimi , S. E., & Hattaoui, M. E. (2023). Heart Arrest Revealing a Killer Coronary Artery. Asian Journal of Cardiology Research, 6(1), 414–419. Retrieved from https://journalajcr.com/index.php/AJCR/article/view/188


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Engel HJ, Torres C, Page HL. Major variations in anatomical origin of the coronary arteries: Angiographic Observations in 4,250 Patients without Associated Congenital Heart Disease. Cathet Cardiovasc Diagn. 1975;1(2):157–169.

Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol. 1992;20(3):640–647.

Kastellanos S, Aznaouridis K, Vlachopoulos C, Tsiamis E, Oikonomou E, Tousoulis D. Overview of coronary artery variants, aberrations and anomalies. World J Cardiol. 2018;10(10):127–140.

Angelini P. Normal and anomalous coronary arteries: definitions and classification. Am Heart J. 1989;117(2): 418–434.

Villa AD, Sammut E, Nair A, Rajani R, Bonamini R, Chiribiri A. Coronary artery anomalies overview: The normal and the abnormal. World J Radiol. 2016;8(6):537–555.

Young PM, Gerber TC, Williamson EE, Julsrud PR, Herfkens RJ. Cardiac imaging: Part 2, normal, variant, and anomalous configurations of the coronary vasculature. AJR Am J Roentgenol. 2011;197(4):816–826.

Yuan S-M. Anomalous origin of coronary artery: taxonomy and clinical implication. Rev Bras Cir Cardiovasc. 2014;29(4):622–629.

Gentile F, Castiglione V, De Caterina R. Coronary artery anomalies. Circulation. 2021;144(12):983–996.

Cheezum MK, Liberthson RR, Shah NR, Villines TC, O’Gara PT, Landzberg MJ, et al. Anomalous Aortic Origin of a Coronary Artery From the Inappropriate Sinus of Valsalva. J Am Coll Cardiol. 2017;69(12):1592–1608.

Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990;21(1):28–40.

Burke AP, Farb A, Virmani R, Goodin J, Smialek JE. Sports-related and non-sports-related sudden cardiac death in young adults. Am Heart J. 1991;121(2 Pt 1):568–575.

Maron BJ, Poliac LC, Roberts WO. Risk for sudden cardiac death associated with marathon running. J Am Coll Cardiol. 1996;28(2):428–431.

Trivellato M, Angelini P, Leachman RD. Variations in coronary artery anatomy: Normal versus abnormal. Cardiovasc Dis. 1980;7(4):357–370.

Cheitlin MD, De Castro CM, McAllister HA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva, A not-so-minor congenital anomaly. Circulation. 1974; 50(4):780–787.

Virmani R, Chun PK, Goldstein RE, Robinowitz M, McAllister HA. Acute takeoffs of the coronary arteries along the aortic wall and congenital coronary ostial valve-like ridges: Association with sudden death. J Am Coll Cardiol. 1984;3(3):766–771.

Coronary Artery Axial Plaque Stress and its Relationship With Lesion Geometry: Application of computational fluid dynamics to coronary CT angiography | JACC: Cardiovascular Imaging; 2015 Available:https://www.jacc.org/doi/abs/10.1016/j.jcmg. Accessed on: 11 November 2023.

Han P, Diao K, Huang S, Gao Y, Guo Y, Yang Z, et al. Anatomical characteristics of anomalous left coronary artery from the opposite sinus (left-ACAOS) and its clinical relevance: A serial coronary CT angiography study. IJC Heart & Vasculature. 2020;31:100649.

Samady H, Molony DS, Coskun AU, Varshney AS, De Bruyne B, Stone PH. Risk stratification of coronary plaques using physiologic characteristics by CCTA: Focus on shear stress. Journal of Cardiovascular Computed Tomography. 2020;14(5):386–393.

Ford TJ, Berry C, De BB, Yong ASC, Barlis P, Fearon WF, et al. Physiological Predictors of Acute Coronary Syndromes. JACC: Cardiovascular Interventions. 2017; 10(24):2539–2547.

McConnell MV, Ganz P, Selwyn AP, Li W, Edelman RR, Manning WJ. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation. 1995; 92(11):3158–3162.

Wu GR, Saini A, Ahmed I, Finch C. Interarterial course of anomalous right coronary artery: Pathophysiology, diagnosis, and treatment. Radiol Case Rep. 2017;12(4):664–667.

Flessas D, Mamarelis I, Maniatis V, Souretis G, Laschos N, Kotoulas C, et al. An unusual pattern of three major components of the cardiovascular system: multimodality imaging and review of the literature. J Cardiothorac Surg. 2013;8: 61.

Shriki JE, Shinbane JS, Rashid MA, Hindoyan A, Withey JG, DeFrance A, et al. Identifying, characterizing, and classifying congenital anomalies of the coronary arteries. Radiographics. 2012;32(2):453–468.

Gać P, Żórawik A, Poręba R. A single coronary artery originating from the right coronary sinus with a typical course of the right coronary artery and the interarterial course of the left main, Left Anterior Descending, and Left Circumflex as an Example of a Rare Case of High-Risk Coronary Anomaly. Diagnostics. 2022;12 (1):167.

Agarwal PP, Dennie C, Pena E, Nguyen E, LaBounty T, Yang B, et al. Anomalous coronary arteries that need intervention: review of pre- and postoperative imaging appearances. Radiographics. 2017;37(3): 740–757.