13 yr old girl presented with exercise-related ischemia. Investigations showed this anomaly. Videos of angiograms and echocardiogram are available at JACC online version.
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Hiroshi Nishino, MD*, Kenji Suda, MD*,Yozo Teramachi, MD*, Shintaro Kishimoto, MD*,Kei Goto, MD
and Motofumi Iemura, MD** Department of Pediatrics and Child Health, Kurume University, Kurume, Japan
Department of Pediatric Cardiology, Kumamoto City Hospital, Kumamoto, Japan
A 13-year-old girl was referred to us after an episode of post-exercise ischemic heart event. Ascending aortography, left coronary angiography (Online Videos 1A and 1B), multidetector X-ray computed tomography (A to C), and transesophageal echocardiography (Online Videos 2A and 2B) showed sequestration of the left coronary sinus by the aortic valve leaflet. Stress myocardial scintigraphy revealedperfusion defect, suggesting anteroseptal myocardial ischemia. The patient is scheduled to have corrective operation. This case illustrates that entrapment of the left coronary artery ostium can be one of the causes of ischemic heart disease (1,2).
13 yr old girl presented with exercise-related ischemia. Investigations showed this anomaly. Videos of angiograms and echocardiogram are available at JACC online version.
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