In Syncope or Sudden Death from Coronary Artery Anomalies, Hypotension and Bradycardia are More Frequent than Ventricular Fibrillation.

The article reports about anomalous origin of the left coronary artery from the opposite sinus of Valsalva with an intramural aortic course (L-ACAOS-IM), which is a rare and often misunderstood condition. It also mentions how severe coronary artery anomalies with an intramural course and proximal stenosis frequently lead to syncope during strenuous exertion, which can be the first clear sign of severe disease, and how less often, these anomalies cause sudden cardiac arrest or death.