Remedy Publications LLC. Annals of Cardiology and Cardiovascular Medicine 2019 | Volume 3 | Issue 3 | Article 1029 1 High-Risk Coronary Artery Anomalies, the Second Most Common Cause of Sudden Cardiac Death in Young People: A Case Study OPEN ACCESS *Correspondence: Sarabjeet Singh, Department of Cardiology, Central Cardiology Medical Center, 2901 Sillect Avenue Suite 100, Bakersfeld, CA 93308, USA, E-mail: ssingh@heart24.com Received Date: 13 Sep 2019 Accepted Date: 27 Sep 2019 Published Date: 11 Oct 2019 Citation: Civelli VF, Sharma R, Sharma O, Sharma P, Singh R, Singh S. High-Risk Coronary Artery Anomalies, the Second Most Common Cause of Sudden Cardiac Death in Young People: A Case Study. Ann Cardiol Cardiovasc Med. 2019; 3(3): 1029. Copyright © 2019 Sarabjeet Singh. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Case Report Published: 11 Oct, 2019 Introduction Anatomical variations of the coronary arteries can range from fstulas to degrees of angulation to sites of origin [1]. While most of these anomalies do not pose a signifcant functional threat, there are a few that have been known to increase risk of death [2]. Providers should be concerned about these high-risk situations known to cause arrhythmias, heart attacks and sudden cardiac death. We will identify those concerning aberrations, understand the population at risk, identify how they present and make recommendations. Methods Chart review of case study patient. Literature review: searched “coronary artery anomalies”, “sudden cardiac death/arrest”, and “malignant coronary artery anatomy”. Case Presentation 34-year old male patient presented to his Primary Care Physician (PCP) with complaints of worsening chest pain. He is a non-smoker and denied alcohol or drug use but had strong family history of premature coronary artery disease on both his maternal and paternal sides. His Body Mass Index (BMI) was 36. Electrocardiogram (EKG) showed normal sinus rhythm, normal axis and Interventricular Conduction Delay (IVCD) (Figure 1). He had a history of essential hypertension and had been recently started on blood pressure lowering medication Hydrochlorothiazide (HCTZ) and cholesterol lowering medication Crestor. Calcium score was ordered and found to be 291, with greatest contribution coming from the right coronary artery, placing him at 90 th percentile on MESA scale. See calcium score distribution in Figure 2. Two-dimensional (2D) echocardiogram was done and showed mild concentric lef ventricular hypertrophy with normal Ejection Fractions (EF) of 60% to 65%. No valvular abnormalities were detected (Figure 3). Nuclear Medicine (NM) stress test and Single Positron Emission Computerized Test (SPECT) Abstr act It is our intention to present an atypical case of a high-risk coronary artery anomaly to draw awareness and reduce mortality from Sudden Cardiac Death (SCD) syndrome. SCD is the second most common cause of high risk coronary anomalies in young people and nearly half a million lives are taken per year from this condition. We present a young, sedentary, symptomatic 34-year-old male patient who presented to his Primary Care Physician (PCP) with complaints of worsening chest pain. He is a non-smoker and denied alcohol or drug use but had strong family history of premature coronary artery disease on both his maternal and paternal sides. Tis case is impactful because it shows a non-athlete profle which is an outlier to the majority of literature which tends to portray only athletes and highly active patients. Keywords: Coronary artery anomaly; Sudden cardiac death; Sudden cardiac arrest Valerie F Civelli 1 , Ritika Sharma 1 , Ojas Sharma 1 , Parikshat Sharma 2 , Raman Singh 3 and Sarabjeet Singh 1 * 1 Department of Cardiology, Central Cardiology Medical Center, USA 2 Department of Cardiology, Golden State Hospitalists Group, USA 3 Department of Cardiology, Hull York Medical School, UK