All issues > Volume 53(2); 2010

Case Report

Korean J Pediatr. 2010;53(2):248-252. Published online February 15, 2010.

Anomalous origin of left coronary artery arising from the right coronary cusp presenting with chest discomfort and syncope on physical exercise

Ran R Baik¹, Nam Kyun NK Kim¹, Han Ki HK Park², Young Hwan YH Park², Byung Won BW Yoo¹, Jae Young JY Cho¹

¹Division of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
²Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea

Correspondence Jae Young JY Cho ,Tel: +82.2-2228-8280, Fax: +82.2-393-3080, Email: cjy0122@yuhs.ac

Abstract

Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA) in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG), and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE) and heart computed tomography (CT). She underwent a corrective operation by re-implantation, CABG, and unroofing.

Keywords :Coronary Vessel Anomalies, Coronary Artery Bypass, Acute Coronary Syndrome, Syncope