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Erschienen in: Rechtsmedizin 2/2015

01.04.2015 | Kasuistiken

Koronaranomalie als Todesursache bei einem 13 Monate alt gewordenen Jungen

Fehlabgang der rechten Koronararterie aus dem linken Aortensinus

verfasst von: S. Stockhausen, K. Wöllner, B. Madea, E. Doberentz

Erschienen in: Rechtsmedizin | Ausgabe 2/2015

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Zusammenfassung

Hintergrund

Ursprungs- und Verlaufsanomalien von Koronararterien können ernsthafte und sogar tödliche Folgen haben.

Material und Methode

Es wird ein Fall vorgestellt, bei dem ein 13 Monate alter Junge am Morgen leblos von seinen Pflegeeltern in seinem Bett aufgefunden wurde. Der hinzu gerufene Notarzt hatte noch versucht, den Jungen zu reanimieren. In der Kinderklinik, in die er eingeliefert wurde, wurde jedoch nur noch der Tod festgestellt. Bei der Obduktion zeigte sich der Abgang der rechten Herzkranzarterie anatomisch falsch über dem Abgang der linken Herzkranzarterie im linken Sinus Valsalvae mit Verlauf der rechten Herzkranzarterie zwischen Körperhaupt- und Lungenschlagader lokalisiert.

Ergebnisse und Schlussfolgerung

Der atypische Abgang der rechten Koronararterie aus dem linken Sinus wird als eher gutartig angesehen. Die Obduktionsergebnisse beleuchten diese Art der Koronaranomalie und stellen dessen vermeintliche Benignität infrage.
Literatur
1.
Zurück zum Zitat Albalooshi Y, Hagemeier L, Doberentz E, Madea B (2008) Abgang der rechten Herzkranzarterie aus einem Aneurysma des Sinus Valsalvae. Rechtsmedizin 18:437–440CrossRef Albalooshi Y, Hagemeier L, Doberentz E, Madea B (2008) Abgang der rechten Herzkranzarterie aus einem Aneurysma des Sinus Valsalvae. Rechtsmedizin 18:437–440CrossRef
2.
Zurück zum Zitat Alexander RW, Griffith GC (1956) Anomalies of the coronary arteries and their clinical significance. Circulation 14(5):800–805CrossRefPubMed Alexander RW, Griffith GC (1956) Anomalies of the coronary arteries and their clinical significance. Circulation 14(5):800–805CrossRefPubMed
3.
Zurück zum Zitat Angelini P, Walmsley RP, Libreros A, Ott DA (2006) Symptomatic anomalous origination of the left coronary artery from the opposite sinus of valsalva: clinical presentations, diagnosis, and surgical repair. Tex Heart Inst J 33(2):171–179PubMedCentralPubMed Angelini P, Walmsley RP, Libreros A, Ott DA (2006) Symptomatic anomalous origination of the left coronary artery from the opposite sinus of valsalva: clinical presentations, diagnosis, and surgical repair. Tex Heart Inst J 33(2):171–179PubMedCentralPubMed
4.
Zurück zum Zitat Barth CW 3rd, Bray M, Roberts WC (1986) Sudden death in infancy associated with origin of both left main and right coronary arteries from a common ostium above the left sinus of Valsalva. Am J Cardiol 57(4):365–366CrossRefPubMed Barth CW 3rd, Bray M, Roberts WC (1986) Sudden death in infancy associated with origin of both left main and right coronary arteries from a common ostium above the left sinus of Valsalva. Am J Cardiol 57(4):365–366CrossRefPubMed
5.
Zurück zum Zitat Benge W, Martins JB, Funk DC (1980) Morbidity associated with anomalous origin of the right coronary artery from the left sinus of Valsalva. Am Heart J 99:96–100CrossRefPubMed Benge W, Martins JB, Funk DC (1980) Morbidity associated with anomalous origin of the right coronary artery from the left sinus of Valsalva. Am Heart J 99:96–100CrossRefPubMed
6.
Zurück zum Zitat Bunai Y, Akaza K, Tsujinaka M et al (2001) Anomalous origin of the right coronary artery from the left sinus of Valsalva: report of two cases. Forensic Sci Int 123(2–3):254–256 Bunai Y, Akaza K, Tsujinaka M et al (2001) Anomalous origin of the right coronary artery from the left sinus of Valsalva: report of two cases. Forensic Sci Int 123(2–3):254–256
7.
Zurück zum Zitat Byard RW (2010) Sudden death in the young. Cambridge University Press, Cambridge Byard RW (2010) Sudden death in the young. Cambridge University Press, Cambridge
8.
Zurück zum Zitat Davis JA, Cecchin F, Jones TK, Portman MA (2001) Major coronary artery anomalies in a pediatric population: incidence and clinical importance. J Am Coll Cardiol 37(2):593–597CrossRefPubMed Davis JA, Cecchin F, Jones TK, Portman MA (2001) Major coronary artery anomalies in a pediatric population: incidence and clinical importance. J Am Coll Cardiol 37(2):593–597CrossRefPubMed
9.
Zurück zum Zitat Duran AC, Angelini A, Frescura C et al (1994) Anomalous origin of the right coronary artery from the left aortic sinus and sudden infant death. Int J Cardiol 45:147–149CrossRefPubMed Duran AC, Angelini A, Frescura C et al (1994) Anomalous origin of the right coronary artery from the left aortic sinus and sudden infant death. Int J Cardiol 45:147–149CrossRefPubMed
10.
Zurück zum Zitat Frescura C, Basso C, Thiene G et al (1998) Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease. Hum Pathol 29(7):689–695CrossRefPubMed Frescura C, Basso C, Thiene G et al (1998) Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease. Hum Pathol 29(7):689–695CrossRefPubMed
11.
Zurück zum Zitat Gaudin R, Raisky O, Vouhé PR (2014) Anomalous aortic origin of coronary arteries: ‚anatomical‘ surgical repair. Multimed Man Cardiothorac Surg 2014:mmt022CrossRefPubMed Gaudin R, Raisky O, Vouhé PR (2014) Anomalous aortic origin of coronary arteries: ‚anatomical‘ surgical repair. Multimed Man Cardiothorac Surg 2014:mmt022CrossRefPubMed
12.
Zurück zum Zitat Hanzlick RL, Stivers RR (1983) Sudden death due to anomalous right coronary artery in a 26-year-old marathon runner. Am J Forensic Med Pathol 4(3):265–268CrossRefPubMed Hanzlick RL, Stivers RR (1983) Sudden death due to anomalous right coronary artery in a 26-year-old marathon runner. Am J Forensic Med Pathol 4(3):265–268CrossRefPubMed
13.
Zurück zum Zitat Hill SF, Sheppard MN (2013) A silent cause of sudden cardiac death especially in sport: congenital coronary artery anomalies. Br J Sports Med 48(15):1151–1156CrossRefPubMed Hill SF, Sheppard MN (2013) A silent cause of sudden cardiac death especially in sport: congenital coronary artery anomalies. Br J Sports Med 48(15):1151–1156CrossRefPubMed
14.
Zurück zum Zitat Kimbiris D (1985) Anomalous origin of the left main coronary artery from the right sinus of Valsalva. Am J Cardiol 55(6):765–769CrossRefPubMed Kimbiris D (1985) Anomalous origin of the left main coronary artery from the right sinus of Valsalva. Am J Cardiol 55(6):765–769CrossRefPubMed
15.
Zurück zum Zitat Kragel AH, Roberts WC (1988) Anomalous origin of either the right or left main coronary artery from the aorta with subsequent coursing between aorta and pulmonary trunk: analysis of 32 necropsy cases. Am J Cardiol 62:771–777CrossRefPubMed Kragel AH, Roberts WC (1988) Anomalous origin of either the right or left main coronary artery from the aorta with subsequent coursing between aorta and pulmonary trunk: analysis of 32 necropsy cases. Am J Cardiol 62:771–777CrossRefPubMed
16.
Zurück zum Zitat Liberthson RR, Gang DL, Custer J (1983) Sudden death in an infant with aberrant origin of the right coronary artery from the left sinus of Valsalva of the aorta: case report and review of the literature. Pediatr Cardiol 4(1):45–48CrossRefPubMed Liberthson RR, Gang DL, Custer J (1983) Sudden death in an infant with aberrant origin of the right coronary artery from the left sinus of Valsalva of the aorta: case report and review of the literature. Pediatr Cardiol 4(1):45–48CrossRefPubMed
17.
Zurück zum Zitat Lipsett J, Byard RW, Carpenter BF et al (1991) Anomalous coronary arteries arising from the aorta associated with sudden death in infancy and early childhood. An autopsy series. Arch Pathol Lab Med 115(8):770–773PubMed Lipsett J, Byard RW, Carpenter BF et al (1991) Anomalous coronary arteries arising from the aorta associated with sudden death in infancy and early childhood. An autopsy series. Arch Pathol Lab Med 115(8):770–773PubMed
18.
Zurück zum Zitat Madea B (1995) Plötzlicher Herztod bei Ursprungsanomalie der linken Herzkranzarterie mit anteriorem Verlauf. Z Rechtsmed 6:53–57 Madea B (1995) Plötzlicher Herztod bei Ursprungsanomalie der linken Herzkranzarterie mit anteriorem Verlauf. Z Rechtsmed 6:53–57
19.
Zurück zum Zitat Madea B, Dettmeyer R (1998) Sudden death in cases of ectopic origin of the left coronary artery. Forensic Sci Int 96:91–100CrossRefPubMed Madea B, Dettmeyer R (1998) Sudden death in cases of ectopic origin of the left coronary artery. Forensic Sci Int 96:91–100CrossRefPubMed
20.
Zurück zum Zitat Madea B, Saukko P, Oliva A, Musshoff F (2010) Molecular pathology in forensic medicine - Introduction. Forensic Sci Int 203(1–3):3–14 Madea B, Saukko P, Oliva A, Musshoff F (2010) Molecular pathology in forensic medicine - Introduction. Forensic Sci Int 203(1–3):3–14
21.
Zurück zum Zitat Maresi E, Orlando E, Becchina G et al (1993) Anomalous origin of the right coronary from the left sinus of Valsalva. A possible cause of juvenile sudden death. G Ital Cardiol 23(10):995–1003PubMed Maresi E, Orlando E, Becchina G et al (1993) Anomalous origin of the right coronary from the left sinus of Valsalva. A possible cause of juvenile sudden death. G Ital Cardiol 23(10):995–1003PubMed
22.
Zurück zum Zitat Marler AT, Malik JA, Slim AM (2013) Anomalous left main coronary artery: case series of different courses and literature review. Case Rep Vasc Med 2013:380952PubMedCentralPubMed Marler AT, Malik JA, Slim AM (2013) Anomalous left main coronary artery: case series of different courses and literature review. Case Rep Vasc Med 2013:380952PubMedCentralPubMed
23.
Zurück zum Zitat Murphy DA, Roy DL, Sohal M, Chandler BM (1978) Anomalous origin of left main coronary artery from anterior sinus of Valsalva with myocardial infarction. J Thorac Cardiovasc Surg 75(2):282–285PubMed Murphy DA, Roy DL, Sohal M, Chandler BM (1978) Anomalous origin of left main coronary artery from anterior sinus of Valsalva with myocardial infarction. J Thorac Cardiovasc Surg 75(2):282–285PubMed
24.
Zurück zum Zitat Muus CJ, McManus BM (1984) Common origin of right and left coronary arteries from the region of left sinus of Valsalva: association with unexpected intrauterine fetal death. Am Heart J 107(6):1285–1286CrossRefPubMed Muus CJ, McManus BM (1984) Common origin of right and left coronary arteries from the region of left sinus of Valsalva: association with unexpected intrauterine fetal death. Am Heart J 107(6):1285–1286CrossRefPubMed
25.
Zurück zum Zitat Ness MJ, McManus BM (1988) Anomalous right coronary artery origin in otherwise unexplained infant death Arch Pathol Lab Med 112(6):626–629 Ness MJ, McManus BM (1988) Anomalous right coronary artery origin in otherwise unexplained infant death Arch Pathol Lab Med 112(6):626–629
26.
Zurück zum Zitat Qin X, Xiong W, Guan E, Lu C (2013) Coronary anomaly: anomalous right coronary artery originates from the left sinus of Valsalva and coursing between the pulmonary artery and aorta. Clin Interv Aging 8:1217–1220CrossRefPubMedCentralPubMed Qin X, Xiong W, Guan E, Lu C (2013) Coronary anomaly: anomalous right coronary artery originates from the left sinus of Valsalva and coursing between the pulmonary artery and aorta. Clin Interv Aging 8:1217–1220CrossRefPubMedCentralPubMed
27.
Zurück zum Zitat Roberts WC, Siegel RJ, Zipes DP (1982) Origin of the right coronary artery from the left sinus of Valsalva and its functional consequences: analysis of 10 necropsy patients. Am J Cardiol 49:863–868CrossRefPubMed Roberts WC, Siegel RJ, Zipes DP (1982) Origin of the right coronary artery from the left sinus of Valsalva and its functional consequences: analysis of 10 necropsy patients. Am J Cardiol 49:863–868CrossRefPubMed
28.
Zurück zum Zitat Steinberger J, Lucas RV, Edwards JE, Titus JL (1996) Causes of sudden unexpected cardiac death in the first two decades of life. Am J Cardiol 77:992–995CrossRefPubMed Steinberger J, Lucas RV, Edwards JE, Titus JL (1996) Causes of sudden unexpected cardiac death in the first two decades of life. Am J Cardiol 77:992–995CrossRefPubMed
29.
Zurück zum Zitat Stowens D (1959) Pediatric pathology, 3. Aufl. Williams & Wilkins, Baltimore Stowens D (1959) Pediatric pathology, 3. Aufl. Williams & Wilkins, Baltimore
30.
Zurück zum Zitat Swaminath D, Panikkath R, Strefling J et al (2013) Anomalous right coronary artery from left main coronary artery and subsequent coursing between aorta and pulmonary trunk. Case Rep Med 2013:195026PubMedCentralPubMed Swaminath D, Panikkath R, Strefling J et al (2013) Anomalous right coronary artery from left main coronary artery and subsequent coursing between aorta and pulmonary trunk. Case Rep Med 2013:195026PubMedCentralPubMed
31.
Zurück zum Zitat Szymczyk K, Polgu M, Szymczyk E et al (2014) Prevalence of congenital coronary artery anomalies and variants in 726 consecutive patients based on 64-slice coronary computed tomography angiography. Folia Morphol (Warsz) 73(1):51–57 Szymczyk K, Polgu M, Szymczyk E et al (2014) Prevalence of congenital coronary artery anomalies and variants in 726 consecutive patients based on 64-slice coronary computed tomography angiography. Folia Morphol (Warsz) 73(1):51–57
32.
Zurück zum Zitat Taylor AJ, Rogan KM, Virmani RJ (1992) Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol 20(3):640–647CrossRefPubMed Taylor AJ, Rogan KM, Virmani RJ (1992) Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol 20(3):640–647CrossRefPubMed
33.
Zurück zum Zitat Taylor AJ, Byers JP, Cheitlin MD, Virmani R (1997) Anomalous right or left coronary artery from the contralateral coronary sinus: „High-risk“ abnormalities in the initial coronary artery course and heterogeneous clinical outcomes. Am Heart J 133(4):428–435CrossRefPubMed Taylor AJ, Byers JP, Cheitlin MD, Virmani R (1997) Anomalous right or left coronary artery from the contralateral coronary sinus: „High-risk“ abnormalities in the initial coronary artery course and heterogeneous clinical outcomes. Am Heart J 133(4):428–435CrossRefPubMed
34.
Zurück zum Zitat Thierauf A, Dettmeyer R, Wollersen H, Madea B (2007) Aplastic right coronary artery and left coronary artery with a separate origin of the circumflex branch in a 31-year-old woman. Forensic Sci Int 173(2–3):178–181 Thierauf A, Dettmeyer R, Wollersen H, Madea B (2007) Aplastic right coronary artery and left coronary artery with a separate origin of the circumflex branch in a 31-year-old woman. Forensic Sci Int 173(2–3):178–181
35.
Zurück zum Zitat Virmani R, Chun PK, Goldstein RE et al (1984) Acute takeoffs of the coronary arteries along the aortic wall and congenital coronary ostial valve-like ridges: association with sudden death. J Am Coll Cardiol 3:766–771CrossRefPubMed Virmani R, Chun PK, Goldstein RE et al (1984) Acute takeoffs of the coronary arteries along the aortic wall and congenital coronary ostial valve-like ridges: association with sudden death. J Am Coll Cardiol 3:766–771CrossRefPubMed
36.
Zurück zum Zitat Winkel BG, Risgaard B, Sadjadieh G et al (2014) Sudden cardiac death in children (1–18 years): symptoms and causes of death in a nationwide setting. Eur Heart J 35(13):868–875CrossRefPubMed Winkel BG, Risgaard B, Sadjadieh G et al (2014) Sudden cardiac death in children (1–18 years): symptoms and causes of death in a nationwide setting. Eur Heart J 35(13):868–875CrossRefPubMed
37.
Zurück zum Zitat Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 21(1):28–40CrossRefPubMed Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 21(1):28–40CrossRefPubMed
Metadaten
Titel
Koronaranomalie als Todesursache bei einem 13 Monate alt gewordenen Jungen
Fehlabgang der rechten Koronararterie aus dem linken Aortensinus
verfasst von
S. Stockhausen
K. Wöllner
B. Madea
E. Doberentz
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Rechtsmedizin / Ausgabe 2/2015
Print ISSN: 0937-9819
Elektronische ISSN: 1434-5196
DOI
https://doi.org/10.1007/s00194-014-1002-1

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