Anomalous origin of the left coronary artery.

Two autopsy cases of anomalous coronary artery were reported. The patients were a schoolgirl and a schoolboy, who died suddenly during physical exercise at the age of twelve. At postmortem examination in both cases the left coronary artery arose at the comissure from aorta, and in one case the left coronary ostium was completely obstructed with fibrous tissue, whereas in the other case it was severely stenotic. The cause of anomalous ostial position should be regarded as congenital, but the complete occlusion and severe stenosis at the orifice seemed to be modified by several factors--both congenital acquired. For the prevention of sudden death caused by this anomaly, cardiac angiography would have been necessary at the outset of anginal pain.