PMC6434098_01
Non sustained ventricular tachycardia at exercise stress test (treadmill).
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ECG was normal, with sinus rhythm, normal heart rate in the absence of significant alterations of the ventricular repolarization phase (QTma x 413 ms, QTmin 383 ms, QTd 39 ms, QTcd 44 ms). Exercise stress test (treadmill) didn't show signs of inducible ischemia through maximal effort (METS 21, HR max 194 beats per minutes), but induced asymptomatic non sustained ventricular tachycardia, with left bundle branch morphology an inferior axis with a rate of 150 beats per minute during the second minute of the recovery phase (Fig. 1).
Cardiac magnetic resonance shows single coronary origin from left coronary sinus with malignant course of the right coronary artery (arrow).
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All the data were confirmed by cardiac magnetic resonance (Fig. 2).
Catheter coronary angiography detects anomalous origin of coronary arteries from left coronary sinus, with slit like right coronary ostium (arrow).
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The coronary angiography showed the rare coronary anomaly pattern (Fig. 3).
Catheter coronary angiography detects a bridging muscle in middle segment of the left anterior descending artery (arrow).
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