Aberrant pathway in an anomaly: pre-excitation syndrome in association with coronary sinus aneurysm

Area of Science:

• Cardiology
• Embryology
• Electrophysiology

Background:

• Congenital coronary sinus anomalies are rare cardiac malformations.
• Accessory atrioventricular pathways can lead to supraventricular tachycardias, including Wolff-Parkinson-White (WPW) syndrome.
• The coexistence of these two conditions is infrequently reported.

Observation:

• This report details a male patient presenting with symptoms suggestive of an accessory pathway.
• Diagnostic evaluation revealed an accessory conducting pathway located within the coronary sinus.
• The patient was diagnosed with Wolff-Parkinson-White (WPW) syndrome.

Findings:

• The study identifies a rare association between a coronary sinus anomaly and an accessory pathway.
• The accessory pathway within the coronary sinus was confirmed as the cause of the patient's WPW syndrome.
• Mapping difficulties associated with coronary sinus anomalies were noted.

Implications:

• The findings suggest a potential embryological link between coronary sinus anomalies and accessory atrioventricular pathways.
• Understanding this association may improve diagnostic and therapeutic strategies for patients with complex congenital heart conditions.
• This case contributes to the literature on rare cardiac anomalies and their electrophysiological consequences.