The Trendy Anomalous Aortic Origin of the Coronaries, Should We Start Revising the Pre-Participation Guidelines?

Anomalous aortic origin has become in the last few years the subject of many reports, it is suggested that it is the second most common cause of sudden death among young athletes and school children. Most of patients, will remain asymptomatic until, ischemia is triggered by intense physical activity inducing myocardial hypoperfusion, with subsequent syncope, chest pain or sudden cardiac death. The asymptomatic nature of this anomaly means that even 12-lead electrocardiogram at rest, will miss the diagnosis, which might mandate adding echocardiography or stress-ECG to the guidelines of preparticipation screening.