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Exercise-Induced Myocardial Ischemia in a Case of Anomalous Origin of the Left Main Coronary Artery from the Noncoronary Sinus of Valsalva

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Abstract

We report a case of anomalous origin of the left main coronary artery (LCA) from the noncoronary sinus of valsalva (LCANCS) in a young healthy patient who presented with syncope and cardiopulmonary arrest during exercise. The enhanced computed tomography showed acute angle take-off (AAT) of LCA, and the exercise stress thallium-201 myocardial scintigraphy demonstrated a large defect at the LCA perfusion region. We propose that the coexistence of AAT and resulting ischemia causes sudden cardiac death during exercise in the patients with LCANCS.

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Acknowledgments

The authors thank Dr. Daisuke Tezuka, Department of Cardiovascular Medicine, Tokyo Medical and Dental University, and Dr. Akira Toriihara, Department of Diagnostic Radiology and Oncology, Tokyo Medical and Dental University, for their assistance with coronary imaging.

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Authors and Affiliations

  1. Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Mitsunori Nishiyama, Shouzaburo Doi, Akiko Matsumoto, Masato Nishioka, Susumu Hosokawa, Akihito Sasaki & Shuki Mizutani

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  1. Mitsunori Nishiyama
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  2. Shouzaburo Doi
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  3. Akiko Matsumoto
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  4. Masato Nishioka
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  5. Susumu Hosokawa
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  6. Akihito Sasaki
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  7. Shuki Mizutani
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Correspondence to Mitsunori Nishiyama.

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Nishiyama, M., Doi, S., Matsumoto, A. et al. Exercise-Induced Myocardial Ischemia in a Case of Anomalous Origin of the Left Main Coronary Artery from the Noncoronary Sinus of Valsalva. Pediatr Cardiol 32, 1028–1031 (2011). https://doi.org/10.1007/s00246-011-0051-4

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  • DOI: https://doi.org/10.1007/s00246-011-0051-4

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