Abstract 11375: Hyperventilation Induced Coronary Vasospasm in a Man With Left Main Atresia With a Single Coronary Artery

Introduction: Coronary anomaly accounts for about a 3rd of sudden deaths in young individuals and coronary vasospasm in an anomalous coronary artery is very rare. Case: A 66 year old male with history of hypertension, diabetes & hyperlipidemia presented with syncope. He reported 2 months of episodic dyspnea, near-syncope, and epigastric pain. Stress cardiac magnetic resonance imaging demonstrated normal myocardial perfusion. While awaiting an electrophysiology study, he was observed to hyperventilate with associated epigastric pain, numbness and tingling followed by syncope with pulseless electrical activity arrest, receiving 2 minutes of cardiopulmonary resuscitation. Post-arrest electrocardiogram demonstrated posterior ST elevation MI so the patient was taken for coronary angiography which revealed congenital left main atresia with a single coronary artery taking the course of the right coronary artery giving rise to the left circumflex via the posterior lateral branch and then the left anterior descend...