JACC. Case reports · 2025
Survival After Cardiac Arrest Due to an Anomalous Right Coronary Artery in a Young Athlete.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Silva-Estrada Jorge A, Gastelum-Bernal Melissa, Díliz-Nava Héctor, Coronado-Centeno Karina, González-Rebeles Carlos, Fabiola Pérez-Juárez, Ríos-Olivares Itzel, Osorio-Ugarte Jair Rafael, Corona-Villalobos Carlos, Palacios-Macedo Alexis
Аннотация
BACKGROUND: A 15-year-old Mexican boy experienced sudden cardiac arrest (SCA) during physical exertion.
CASE SUMMARY: The patient received bystander cardiopulmonary resuscitation. An anomalous aortic origin of the right coronary artery was diagnosed by echocardiography. Extracorporeal membrane oxygenation was initiated for cardiogenic shock. Coronary unroofing was performed. Results of stress perfusion cardiac magnetic resonance imaging were negative for ischemia; myocardial infarction was ruled out. The patient recovered without neurological sequelae.
DISCUSSION: Anomalous coronary arteries are a leading cause of SCA in young athletes. There is a gap in evidence regarding indications for implantable cardioverter-defibrillator implantation in surgically corrected coronary arteries.
TAKE-HOME MESSAGES: Anomalous origin of the coronary arteries causing SCA does not always cause myocardial infarction, leaving chronic ischemia as a possible mechanism for cardiovascular events. Stress perfusion imaging and electrophysiologic consultation should be carried out in following up these patients. An appropriate multidisciplinary approach that can result in excellent outcomes is achievable even in developing countries.
CASE SUMMARY: The patient received bystander cardiopulmonary resuscitation. An anomalous aortic origin of the right coronary artery was diagnosed by echocardiography. Extracorporeal membrane oxygenation was initiated for cardiogenic shock. Coronary unroofing was performed. Results of stress perfusion cardiac magnetic resonance imaging were negative for ischemia; myocardial infarction was ruled out. The patient recovered without neurological sequelae.
DISCUSSION: Anomalous coronary arteries are a leading cause of SCA in young athletes. There is a gap in evidence regarding indications for implantable cardioverter-defibrillator implantation in surgically corrected coronary arteries.
TAKE-HOME MESSAGES: Anomalous origin of the coronary arteries causing SCA does not always cause myocardial infarction, leaving chronic ischemia as a possible mechanism for cardiovascular events. Stress perfusion imaging and electrophysiologic consultation should be carried out in following up these patients. An appropriate multidisciplinary approach that can result in excellent outcomes is achievable even in developing countries.