AIM: To raise awareness of congenital coronary artery anomalies (CCAAs) as an important cause of sudden cardiac death (SCD) in athletes, we describe a cohort of the malignant subset. Defining the key anatomical features for the cardiologist and pathologist to be aware of and detailing a systematic approach to examining the coronary arteries at autopsy. METHODS: Retrospective non-case-controlled analysis of 2304 cases of SCD referred by pathologists between 1994 and January 2012. RESULTS: 31 (1.3%) of the 2304 cases of SCD had CCAAs; 24 men (77%) and 7 women (23%), mean age 28 years (range 16 months-63 years). In 15 cases (48%), SCD occurred during or immediately after physical exertion. Cardiac symptoms were documented to have occurred in only seven patients (23%) prior to SCD. The anomaly had been identified by the referring pathologist in only 11 of the 31 cases (35%). CONCLUSIONS: CCAAs are a rare and mostly benign entity, but a subset has the potential to be fatal without any forewarning. In a significant proportion of cases identified in this large cohort, the victim was under exertion at the time of death, highlighting the relevance of this anomaly to the sports and exercise medicine community. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
AIM: To raise awareness of congenital coronary artery anomalies (CCAAs) as an important cause of sudden cardiac death (SCD) in athletes, we describe a cohort of the malignant subset. Defining the key anatomical features for the cardiologist and pathologist to be aware of and detailing a systematic approach to examining the coronary arteries at autopsy. METHODS: Retrospective non-case-controlled analysis of 2304 cases of SCD referred by pathologists between 1994 and January 2012. RESULTS: 31 (1.3%) of the 2304 cases of SCD had CCAAs; 24 men (77%) and 7 women (23%), mean age 28 years (range 16 months-63 years). In 15 cases (48%), SCD occurred during or immediately after physical exertion. Cardiac symptoms were documented to have occurred in only seven patients (23%) prior to SCD. The anomaly had been identified by the referring pathologist in only 11 of the 31 cases (35%). CONCLUSIONS:CCAAs are a rare and mostly benign entity, but a subset has the potential to be fatal without any forewarning. In a significant proportion of cases identified in this large cohort, the victim was under exertion at the time of death, highlighting the relevance of this anomaly to the sports and exercise medicine community. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Christoph Gräni; Dominik C Benz; Christian Schmied; Jan Vontobel; Fran Mikulicic; Mathias Possner; Olivier F Clerc; Julia Stehli; Tobias A Fuchs; Aju P Pazhenkottil; Oliver Gaemperli; Ronny R Buechel; Philipp A Kaufmann Journal: J Nucl Cardiol Date: 2015-12-28 Impact factor: 5.952
Authors: Nino Cocco; Rosalinda Madonna; Valeria Cammalleri; Giulio Cocco; Domenico De Stefano; Danilo Ricciardi; Francesco Grigioni; Gian Paolo Ussia Journal: Front Cardiovasc Med Date: 2022-07-29