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Anomalous coronary origin: the challenge in preventing exercise-related sudden cardiac death
  1. C P Edwards1,3,
  2. A Yavari1,
  3. M N Sheppard2,
  4. S Sharma1,3
  1. 1Department of Cardiology, University Hospital Lewisham, London, UK
  2. 2Department of Pathology, Royal Brompton Hospital, London, UK
  3. 3Department of Cardiology, King's College Hospital, London, UK
  1. Correspondence to Dr S Sharma, Department of Cardiology, Kings College Hospital, Denmark Hill, London SE5 9RS, UK; sanjay.sharma{at}


The sudden cardiac death (SCD) of a young athlete is a catastrophic event, particularly in the absence of prodromal warning symptoms. Anomalous coronary origin (ACO) is a well-described cause of cardiac symptoms and SCD, but the diagnosis is usually missed by conventional non-invasive investigations designed to identify myocardial ischaemia. SCD is preventable by correction of the anomaly. A tragic case of a promising young athlete who had underlying ACO and who presented with prodromal symptoms with multiple “negative” investigations is described to highlight the typical clinical features and outline the difficulties encountered in accurate premortem diagnosis.

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  • Funding CE is funded by a research grant from the charitable organisation Cardiac Risk in the Young.

  • Competing interests None.

  • Patient consent Obtained.