Congenital coronary artery anomaly simulating a ventricular septal defect

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiac Imaging

Background:

• Anomalous origin of the circumflex artery from the right sinus of Valsalva is a rare congenital cardiac anomaly.
• This condition may coexist with other cardiac malformations, complicating diagnosis and treatment.

Observation:

• A 19-year-old male presented with syncope, initially suspected to have subaortic stenosis and a ventricular septal defect based on transthoracic echocardiography.
• Further investigation with transesophageal echocardiography and coronary angiography revealed the anomalous origin of the circumflex artery from the right sinus of Valsalva.

Findings:

• The patient underwent successful surgical resection of the subaortic stenosis.
• No concomitant coronary artery surgery was required.

Implications:

• Accurate pre-operative identification of coronary artery anomalies is critical for surgical success.
• Failure to detect such anomalies can lead to intraoperative complications and adverse patient outcomes.