SUDDEN-DEATH IN PREGNANCY FROM CONGENITAL-MALFORMATION OF THE CORONARY-ARTERIES

We report the case of a 40 yr old previously healthy woman who died su ddenly during her second pregnancy from unusual coronary artery anomal ies. The left anterior descending coronary artery arose from the above of the right sinus of Valsalva 1.1 cm above the ridge in the aorta an d coursed behind the pulmonary valve before it dipped deeply into the myocardium of the interventricular septum. The left circumflex coronar y artery was hypoplastic. The right coronary artery arose also from ab ove the right sinus of Valsalva 1.1 cm above the ridge in the aorta bu t was otherwise normal. A fourth small coronary artery arose between t he origins of the left anterior descending and right coronary artery a nd supplied the outflow tract of the right ventricle. Mild fibrosis wa s present in the interventricular septum. The rest of the autopsy exam ination was unremarkable. Such combination of coronary artery anomalie s causing sudden unexpected death in a pregnant woman have not previou sly been reported.