Syncope in a child owing to intramural course of the left coronary artery

Abstract

Coronary abnormalities are a rare cause of syncope or sudden death in childhood or adolescence. We report on a 14-y-old girl who had suffered for many years from repeated syncope after or during exertion. She had to be resuscitated twice. The left coronary artery arose from the right coronary aortic sinus and took a proximal intramural course. After successful reimplantation, the patient has now been free of symptoms for 12 mo. The pitfalls of differential diagnosis of this rare anomaly are discussed.

Conclusion: Investigation of the coronary anatomy is indicated in otherwise unexplained chest pain, syncope or life-threatening events.