Skip Navigation

European Heart Journal 2003 24(3):289; doi:10.1016/S0195-668X(02)00632-2
Copyright © 2003 by the European Society of Cardiology.
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Barriales-Villa, R.
Right arrow Articles by Morís, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Barriales-Villa, R.
Right arrow Articles by Morís, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Letters to the Editor

Syncope and coronary anomalies

R. Barriales-Villa1 and C. Morís2

1 Complexo Hospitalario de Pontevedra, Spain
2 Hospital Central Asturias, Spain

We have read with interest the article by Colivicchi et al.1 and while congratulating them on their work, we would like to make some comments.

Congenital anomalies of the coronary arteries are an important cause of sudden death in athletes, which should be excluded when one of these presents a syncope. In their work, the authors rule out cardiac disease in the 33 athletes studied, by means of an evaluation which includes a clinical history, physical examination, routine laboratory tests, a 12-lead electrocardiogram, Doppler echocardiography, 24-h electrocardiographic monitoring, exercise testing and an cardiac electrophysiological study.1

We are in complete agreement with the authors on the employment of Doppler echocardiography as a noninvasive technique in the diagnosis of the initial course of coronary anomalies, but it is known thatthere are a small percentage ofpatients with poor echocardiographic windows, which do not allow a complete and safe diagnosis of the initial course.2 Different semi-invasive techniques—transoesophageal echocardiography,3 helicoidal computedtomography,4 magnetic angioresonance5—have been proposed to alleviate this problem.

Have the authors employed any of these semi-invasive techniques or has conventional transthoracic echocardiography been satisfactory in ruling out the presence of coronary anomalies?

References

  1. Colivicchi F, Ammirati F, Biffi A, Verdile L, Pelliccia A, Santini M. Exercise-related syncope in young competitive athletes without evidence of structural heart disease: Clinical presentation and long-term outcome. Eur Heart J. 2002;23:1125–1130 doi:10.1053/euhj.2001.3042[Abstract/Free Full Text]
  2. Pelliccia A, Spataro A, Maron BJ. Prospective echocardiographic screening for coronary artery anomalies in 1360 elite competitive athletes. Am J Cardiol. 1993;72:978–979[CrossRef][Web of Science][Medline]
  3. Fernandes F, Alam M, Smith S, Khaja F. The role of transesophageal echocardiography in identifying anomalous coronary arteries. Circulation. 1993;88:2532–2540[Abstract/Free Full Text]
  4. Barriales-Villa R, Morís C. Usefulness of helical computed tomography in the diagnosis of the initial course of coronary anomalies. Am J Cardiol. 2001;88:719–2540[Web of Science][Medline]
  5. McConnell MV, Ganz P, Selwyn AP, Li W, Edelman RR, Manning WJ. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation. 1995;92:3158–3162[Abstract/Free Full Text]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Barriales-Villa, R.
Right arrow Articles by Morís, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Barriales-Villa, R.
Right arrow Articles by Morís, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?