[The Bland-White-Garland syndrome in adult age]

The clinical and post-mortem findings in a 59-year-old female patient with an anomalous origin of the left coronary artery are described. This case in the age over fifty is the fourth to be published. The clinical picture was characterized as an antero-lateral myocardial infarction with disturbances of the conduction and with a mitral insufficiency. At autopsy fibrotic areas resulting from myocardial infarction were found in the ventricular septum and in the anterior as well in the posterior muscular wall of the heart. The histological alterations of the arterial wall suggested that the function of the central part of the left coronary artery was that of a vene, while the peripheral parts served as arterio-venous anastomoses. The occurrence of this anomaly in our autopsy material was 0.1 0/00. The pathophysiology is discussed.