[Prinzmetal phenomenon and a rare coronary anomaly as infarct and death cause of a 45-year-old patient].

We report about the sudden death of a 45-year-old woman with anomalous origin of both coronary arteries from a single ostium in the right sinus of Valsalva, the left coronary artery running between the aorta and the pulmonary trunk. The clinical picture was that of Prinzmetal's form of variant angina, and it preceded death of inferior myocardial infarction. Coronary spasm and the anatomical anomaly were demonstrated by coronary angiography. There was no atheromatous plaque or other obstructive lesion in the dominant right coronary artery which could have explained the inferior myocardial infarction seen at autopsy. This is the first detailed report in which this rare coronary anomaly has been associated with Prinzmetal's variant angina. The demonstration of spasm in the dominant coronary artery and of an infarct in that part of the myocardium supplied by it in the absence of any anatomical obstruction suggests that this patient's death resulted from coronary spasm.