A 22-year-old athlete has anomalous origin of the left coronary artery from the right sinus with an intramural interarterial course. Stress perfusion

Question

A 22-year-old athlete has anomalous origin of the left coronary artery from the right sinus with an intramural interarterial course. Stress perfusion CMR produces anterior ischaemia and exertional presyncope. What management is preferred?

Accepted Answer

Refer for surgical correction at an experienced congenital coronary centre

Answer

Use a subcutaneous ICD instead of correcting the coronary anatomy

Answer

Treat with aspirin alone and repeat imaging after five years

Answer

Perform alcohol septal ablation to widen the coronary origin

Answer

Permit unrestricted competition because resting LV function is normal

GDMT Withdrawal TRED-HF — EECC MCQ

A 22-year-old athlete has anomalous origin of the left coronary artery from the right sinus with an intramural interarterial course. Stress perfusion CMR produces anterior ischaemia and exertional presyncope. What management is preferred?