Congenital coronary artery anomalies represent a rare cause for cardiac arrest in children and adults; however, most of these anomalies are asymptomatic and incidental findings. We report on a 14-year-old boy who was admitted to our hospital after cardiopulmonary resuscitation at home. Diagnostic workup including histopathology revealed parvovirus B19 in endomyocardial biopsy. Moreover, cardiac catheterisation as well as CT angiography identified an anomalous origin of the right coronary artery with an interarterial course. Since this anomalous coronary artery might have caused impaired myocardial perfusion causing cardiac arrest, surgical correction and implantation of a cardioverter defibrillator were performed. The further post-operative clinical course (7 months) has been uneventful.

The association of complete atrioventricular canal with transposition of the great arteries is rare, with a prevalence of less than 3–5%. We present an 18-month-old patient with a complete atrioventricular canal, side-by-side transposition of the great arteries, and anomalous coronary anatomy, managed initially with pulmonary banding and then by arterial switch with complete atrioventricular canal repair at early infancy.

An 11-year-old male was presented with exertional chest pain and was diagnosed with atresia of the left main coronary artery. A stress nuclear perfusion imaging was negative at initial presentation, and a vasodilator stress cardiac MRI was again negative 5 years later. The patient has fully participated in competitive sports for 6 years with no occurrence of cardiac events.

Anomalous single coronary artery from pulmonary artery is a very rare congenital heart anomaly. Anomalous single coronary artery from pulmonary artery has high mortality rates and poor surgical outcome despite advanced surgical techniques. We report a 4-month-old infant presented by congestive heart failure findings and diagnosed with anomalous single trunk coronary arteries arising from right pulmonary artery.

We report a rare case of anomalous aortic origin of the right coronary artery from the posterior/non-coronary sinus of Valsalva in a 9-year-old male diagnosed during the workup of premature ventricular contractions. The finding was initially noted on transthoracic echocardiogram and further confirmed with computed tomography. The anomalous coronary artery shows a wide ostium with no intramural or interarterial course.

The aim of this study was to determine the left ventricular myocardial deformation and segmental myocardial dysfunction by speckle tracking echocardiography and tissue Doppler imaging among the operated patients with anomalous origin of the left coronary artery from the pulmonary artery. The study was conducted on 12 patients diagnosed with anomalous origin of the left coronary artery from the pulmonary artery, who had been operated upon between 2001 and 2013 at the medical centres of Shiraz University of Medical Sciences, Shiraz, Iran. The mean age of the patients at the time of surgical correction was 12.6 years ranging from 6 months to 43 years, and the duration of postoperative follow-up was between 1 and 12 years. Comparison of the strain rate between the patients with acceptable ejection fraction and the control group by tissue Doppler imaging showed significant differences between the two groups regarding the lateral wall (p<0.001), but not the septal wall of the left ventricle (p=0.65). Moreover, the strain values by the speckle tracking method revealed significant differences between the patient and the control group regarding the global strain (p=0.016) and anterior, lateral, and posterior segments of the left ventricle. Although postoperative conventional echocardiography revealed normal global left ventricular function with acceptable ejection fraction, abnormal myocardial deformation of the variable segments of the left ventricle with regional and global myocardial dysfunction were well defined by speckle tracking echocardiography.

We report a case of two brothers with Marfan syndrome and coexistent anomalous aortic origin of a coronary artery from the wrong sinus of Valsalva. To our knowledge, this is the first ever report of siblings with Marfan syndrome who also have anomalous aortic origin of a coronary artery. The treatment and management options in the context of sudden death risk are discussed.

Woven coronary artery disease is an extremely rare congenital abnormality with unusual findings of branching thin channels and distal reanastomosis. This pathologic finding was reported earlier in a few adult patients. In Kawasaki disease, coronary arterial system is commonly affected, which causes a necessity of cardiac imaging. We report a 9-month-old infant with Kawasaki disease in which left coronary artery aneurysm and woven right coronary artery were coincidentally detected during coronary angiography. After 1 year, coronary angiogram was re-performed and showed no changes in the coronary arteries. During the follow-up period of 4 years, the patient remained asymptomatic. In Kawasaki disease, there is a tendency for thrombus formation and a woven coronary artery can be easily misinterpreted as a thrombus. Woven coronary artery is a benign condition and it should not be confused with a thrombus or a stenosis related finding which needs a medical or surgical intervention.