Sudden death associated with alcohol consumption.

Evaluation of a binge drinker who died suddenly after a weekend of heavy beer consumption, and had been resuscitated successfully, revealed no evidence of clinically detectable heart disease. Baseline electrophysiological testing was normal. Following intravenous ethanol infusion, paired ventricular extrastimuli from the right ventricle induced a rapid polymorphic ventricular tachycardia requiring cardioversion. Repeat electrophysiological testing 24 hours later without alcohol infusion was again normal. The patient was discharged on no medications and was instructed to refrain from drinking alcohol. Approximately 3 months later the patient died suddenly after heavy beer consumption. Alcohol should be considered in the evaluation of survivors of cardiac arrest and alcohol challenge may be useful in their evaluation.

A new double coronary artery anomaly: the right coronary artery originating above the coronary sinus giving off the circumflex artery.

This is the first reported case of a coronary artery anomaly in which the right coronary artery originates above the left sinus of Valsalva and also gives off the circumflex system. Use of the aortogram and careful inspection of the ventriculogram in the right anterior oblique view were most helpful in recognizing the anomaly. The potential pathologic significance of the anomaly and pitfalls of misdiagnosis are discussed.