Coronary artery anomalies are associated often with myocardial ischemia or sudden cardiac death. A 19-year-old woman who participated in an exertive game lost consciousness upon one such exertion. She was taken to a hospital where she died on the same day. An autopsy revealed that she had bifurcated coronary arteries, which arose from one coronary ostium in the left sinus of Valsalva. The right coronary artery arose from the left sinus and traveled between the aorta and the pulmonary trunk. The heart as well as the cardiac conduction system depended exclusively on the single coronary artery ostium for oxygenated blood supply, and the unbalanced blood distribution on her exertion probably led to sudden cardiac death. The case highlights the medicolegal importance of unexpected sudden cardiac death related to an anomalous origin of the coronary arteries.
Autopsy ; Coronary Vessel Anomalies/*complications/pathology ; Coronary Vessels/pathology ; Death, Sudden, Cardiac/*etiology/pathology ; Female ; Humans ; Physical Exertion ; Sinus of Valsalva/abnormalities ; Young Adult

Arrhythmogenic Right Ventricular Dysplasia ; complications ; Autopsy ; Cardiomyopathy, Hypertrophic ; complications ; Cause of Death ; Coronary Disease ; complications ; Coronary Vessel Anomalies ; complications ; Death, Sudden, Cardiac ; etiology ; pathology ; Humans

Cardiomyopathy, Hypertrophic ; etiology ; pathology ; physiopathology ; Coronary Angiography ; Coronary Disease ; complications ; physiopathology ; Coronary Vessel Anomalies ; etiology ; pathology ; physiopathology ; Humans ; Myocardium ; pathology

Cardiomyopathy, Hypertrophic ; etiology ; pathology ; physiopathology ; Coronary Angiography ; Coronary Disease ; complications ; Coronary Vessel Anomalies ; etiology ; pathology ; physiopathology ; Echocardiography ; Humans ; Male ; Middle Aged ; Myocardium ; pathology