Sudden death associated with borderline Hypertrophic Cardiomyopathy and multiple coronary anomalies. Case report and literature review

D. Dermengiu, M. Ceausu, M.C. Rusu, S. Dermengiu, G.C. Curca, S. Hostiuc

Abstract: We report a case of sudden death in a 20 years old male who colapsed just minues after the beggining of a football training session. The autopsy evidenced the presence of a unique combination of coronary abnormalities: myocardial bridging at the level of both branches of the LCA; abnormal origin of the right coronary artery: 1 mm above the left semilunar valve of aorta; the initial segment of the RCA coursing within the aortic wall (0,7 cm); myocardial bridging at the level of LCX; sinoatrial node artery originated from the LCX. Histological examination revealed the presence of Hypertrophic Cardiomyopathy markers within the left ventricle and interventricular septum and the cumulative effects of the coronary cardiac anomalies on the myocardial blood flow: extensive interstitial and perivascular sclerolipomatosis, dissecting fibrosis at the level of the sinoatrial node, subendocardial hyaline fibrosis.
Keywords: circumflex coronary bridging, hypertrophic cardiomyopathy, sinus node fibrosis, anomalous origin of right coronary artery