Premature atherosclerosis: a possible mechanism for symptoms in anomalous coronary arteries--report of a case.

Several mechanisms have been proposed to explain exercise-related sudden deaths and ischemic symptoms in individuals with anomalous coronary artery origin. We report a 21-year-old male track athlete with exercise and rest ischemic symptoms and a right coronary artery (RCA) arising from the left coronary sinus. At surgical reimplantation, his right coronary artery had extensive atherosclerosis despite normallipid levels. This case illustrates anomalous coronary artery origins may produce turbulent flow thereby accelerating atherosclerosis and producing abnormal endothelial function and coronary spasm.