Anomalous coronary artery found in the syncopal workup of an elderly man

Area of Science:

• Cardiology
• Neurology

Background:

• Syncope is a common cause for emergency department visits, categorized as cardiogenic, neurologic, or psychogenic.
• Anomalous coronary arteries are rare causes of syncope, more frequently observed in younger individuals.
• Syncope in patients aged 65 and older is rarely attributed to coronary anomalies.

Observation:

• Two main variants of coronary anomalies exist: left main coronary artery originating from the right aortic sinus and right coronary artery originating from the left aortic sinus.
• The left coronary artery originating from the right aortic sinus carries a higher risk of sudden cardiac death.
• A case of anomalous coronary artery presenting as syncope in a 66-year-old man is presented, a rare occurrence in the United States.

Findings:

• Anomalous coronary arteries can present as syncope, even in elderly patients.
• Systematic diagnostic approaches are crucial for identifying coronary anomalies in syncopal patients.
• Management strategies for anomalous coronary arteries should be considered in syncope workups.

Implications:

• This case underscores the need to consider anomalous coronary arteries in the differential diagnosis of syncope, regardless of patient age.
• Early diagnosis and management of anomalous coronary arteries can potentially prevent adverse cardiovascular events.
• Further research into the prevalence and clinical presentation of coronary anomalies in the elderly population is warranted.