In vivo detection of coronary artery anomalies in asymptomatic athletes by echocardiographic screening

Paolo Zeppilli, Antonio Dello Russo, Cesare Santini, Vincenzo Palmieri, Luigi Natale, Alessandro Giordano, Andrea Frustaci

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Background: Anomalous origin of coronary arteries (AOCA) is a rare congenital disease. Although it may have a benign course, it has been identified as a frequent cause of sports-related sudden death. Unfortunately, in vivo detection of AOCA is not easy, as individuals with this anomaly often are asymptomatic and show no signs of myocardial ischemia. Presently, transthoracic two-dimensional echocardiography (TTE) is the only noninvasive, widely available tool to visualize the ostia and first tracts of coronary arteries. Objective: To assess the efficacy of TTE in the screening of AOCA in a large athletic population. Study design: In a prospective study, we assessed the ostia and first tracts of coronary arteries in 3,650 subjects (mean age, 30±12 years) practicing different sports at various competitive levels. Subjects underwent a TTE examination in our laboratory for scientific or diagnostic purposes. Results: Technically satisfactory echocardiograms were obtained in 3,504 subjects (96%); a clear visualization of the ostia and first tracts of both coronary arteries was obtained in 3,150 cases (90%). Three asymptomatic athletes (0.09%) were suspected to have an AOCA; two with a right coronary artery origin from the left sinus, and one with a left coronary artery origin from the right sinus. Diagnosis was confirmed by coronary angiography. Conclusions: Our study indicated that AOCA is rare in asymptomatic athletes. Systematic and accurate exploration of coronary anatomy in athletes referred for a diagnostic TTE examination may be useful in identifying those with AOCA.

Original languageEnglish
Pages (from-to)89-93
Number of pages5
JournalChest
Volume114
Issue number1
Publication statusPublished - 1998

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Athletes
Coronary Vessels
Echocardiography
Sports
Rare Diseases
Sudden Death
Coronary Angiography
Myocardial Ischemia
Anatomy
Prospective Studies

Keywords

  • Anomalous origin of coronary artery
  • Athletes
  • Echocardiography
  • Sudden death

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

In vivo detection of coronary artery anomalies in asymptomatic athletes by echocardiographic screening. / Zeppilli, Paolo; Dello Russo, Antonio; Santini, Cesare; Palmieri, Vincenzo; Natale, Luigi; Giordano, Alessandro; Frustaci, Andrea.

In: Chest, Vol. 114, No. 1, 1998, p. 89-93.

Research output: Contribution to journalArticle

Zeppilli, P, Dello Russo, A, Santini, C, Palmieri, V, Natale, L, Giordano, A & Frustaci, A 1998, 'In vivo detection of coronary artery anomalies in asymptomatic athletes by echocardiographic screening', Chest, vol. 114, no. 1, pp. 89-93.
Zeppilli P, Dello Russo A, Santini C, Palmieri V, Natale L, Giordano A et al. In vivo detection of coronary artery anomalies in asymptomatic athletes by echocardiographic screening. Chest. 1998;114(1):89-93.
Zeppilli, Paolo ; Dello Russo, Antonio ; Santini, Cesare ; Palmieri, Vincenzo ; Natale, Luigi ; Giordano, Alessandro ; Frustaci, Andrea. / In vivo detection of coronary artery anomalies in asymptomatic athletes by echocardiographic screening. In: Chest. 1998 ; Vol. 114, No. 1. pp. 89-93.
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abstract = "Background: Anomalous origin of coronary arteries (AOCA) is a rare congenital disease. Although it may have a benign course, it has been identified as a frequent cause of sports-related sudden death. Unfortunately, in vivo detection of AOCA is not easy, as individuals with this anomaly often are asymptomatic and show no signs of myocardial ischemia. Presently, transthoracic two-dimensional echocardiography (TTE) is the only noninvasive, widely available tool to visualize the ostia and first tracts of coronary arteries. Objective: To assess the efficacy of TTE in the screening of AOCA in a large athletic population. Study design: In a prospective study, we assessed the ostia and first tracts of coronary arteries in 3,650 subjects (mean age, 30±12 years) practicing different sports at various competitive levels. Subjects underwent a TTE examination in our laboratory for scientific or diagnostic purposes. Results: Technically satisfactory echocardiograms were obtained in 3,504 subjects (96{\%}); a clear visualization of the ostia and first tracts of both coronary arteries was obtained in 3,150 cases (90{\%}). Three asymptomatic athletes (0.09{\%}) were suspected to have an AOCA; two with a right coronary artery origin from the left sinus, and one with a left coronary artery origin from the right sinus. Diagnosis was confirmed by coronary angiography. Conclusions: Our study indicated that AOCA is rare in asymptomatic athletes. Systematic and accurate exploration of coronary anatomy in athletes referred for a diagnostic TTE examination may be useful in identifying those with AOCA.",
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