[Sudden cardiac death in childhood due to and abnormal origin of the coronary arteries].

A seven-year-old girl suddenly collapsed during a sports session at school. An orthostatic syndrome was assumed. In the next two-and-a-half years she experienced four further attacks of weakness with vertigo and vomiting. Paediatric cardiological examination found her to be below the 3rd percentile for height, but the other physical findings and a thoracic radiogram were according to her age. The resting ECG showed increased T waves in V5 and V6, interpreted as signs of vagotonia. Echocardiography was normal, the results of the Schellong test suggested abnormal hypotonic circulatory regulation. Five months later the girl died suddenly after physical exertion. The post-mortem revealed anomalous origin of the left coronary artery (LCA) with a slit-like ostium from the right sinus of Valsalva. The very narrow initial part of the LCA passed tangentially through the wall of the aortic root and then took a leftward course between the aortic root and the pulmonary trunk.--It is assumed that the sudden cardiac death resulted from compression of the intramural segment of the LCA.