Anomalous Left Coronary Artery in Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy and anomalous origin of the coronary artery from the opposite sinus are common causes of sudden cardiac death. These entities have rarely been reported together. Here we present the case of a 48-year-old woman with hypertrophic cardiomyopathy and significant left ventricular outflow tract obstruction. She was referred for septal reduction therapy for symptomatic left ventricular outflow tract obstruction refractory to medical therapy. Cardiac catheterization and coronary artery computed tomography angiogram revealed a single coronary artery arising from the right sinus of Valsalva, coursing between the aorta and the right ventricular outflow tract. The patient underwent septal myectomy and placement of an implantable cardioverter defibrillator.