Sudden Death Associated with Anomalous Left Coronary Artery Origin from Right Sinus of Valsalva with Posterior Course

The left coronary artery from the right sinus of Valsalva represents an incidence of 0.017% of angiographic series and 1.3% of total coronary anomalies of angiographic series. The anomalous left coronary artery arising from the right sinus of Valsalva may take either a septal, anterior, interarterial or posterior course. Sudden death is thought to result from transient occlusion of anomalous left coronary artery, particulary when the anomalous artery passes between the aorta and the pulmonary trunk. The left coronary artery from the right sinus of Valsalva with posterior course are thought to be benign anomalies, although rarely myocardial ischemia may occur. A 69-year old woman died suddenly at rest. Coronary angiography revealed that anomalous left coronary artery origin from right sinus of Valsalva without any significant stenotic lesion, the anomalous left coronary artery passed posterior to the aorta. We report the patient with anomalous origined left coronary artery and its course posterior to aorta associated with the sudden death.

Multicentric Biatrial Myxoma in a Young Female Patient

We report a case of multicentric, biatrial cardiac myxoma in a 29-year-old female who complained of exertional dyspnea, abdominal distension and peripheral edema. Any other associated skin lesions, breast mass or endocrine disorder presenting complex form were not seen on her. Also, there was no contributory medical history, hypertension and diabetes mellitus. By using transthoracic echocardiography, we identified a biatrial myxoma attached to the interatrial septum. During surgical excision, we found a large right atrial myxoma with extension through the fossa ovalis into the left atrium and small myxoma attached to the right atrial free wall. After successful resection of interatrial septum and free wall, atrial septal defect was created during the resection and safely repaired by bovine pericardial patch.

A Case of Cardiac Tamponade due to Primary Hypothyroidism

Pericardial effusions occur in approximately 30% of patients with untreated hypothyroidism. The effusions are more common in patients with longstanding, severe disease. But, cardiac tamponade is a very rare complication, because of the elasticity of pericardium and slow progression. We experienced a 61 year old female patient with cardiac tamponade due to primary hypothyroidism. She was treated with pericardiocentensis and thyroid hormone replacement, confirmed by echocardiography,thyroid function test and TRH stimulation test.