An Unusual Culprit: Syncope in an Adolescent With Congenital Left Main Coronary Artery Atresia

The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...

The cardiac cycle describes the events from one heartbeat to the next. It includes three main phases: diastole, atrial systole, and ventricular systole, all driven by changes in chamber pressures and the function of heart valves.
Diastole: The Relaxation Phase
During diastole, all four heart chambers relax. The atrioventricular (AV) valves open, and the semilunar valves close. This phase sees the lowest chamber pressures, promoting ventricular filling. Venous blood enters the heart through the...

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops: