Sudden cardiac death in a young athlete due to anomalous origin of both coronaries from a common ostium

Sudden cardiac death (SCD) in young people is a tragic event and a worldwide public health issue. SCD is the most common cause of death in young athletes and is related to acquired/congenital cardiac disorders, such as cardiomyopathies, congenital coronary anomalies and ion channelopathies. We report the case of a 14-year-old male non professional athlete who was apparently healthy but suddenly died during a football game. His clinical history was negative for any significant medical illness. At autopsy, a congenital anomalous origin of both the right and left coronary arteries from a single aortic ostium above the aortic cusp was observed with a concomitant hypertophic cardiomyopathy (HCM) The toxicological analysis was negative for common drugs of abuse. The death was attributed to SCD due to hyperkinetic ventricular arrhythmia secondary to myocardial ischemia in a subject with an anomalous origin of both coronary arteries and underlying hypertrophic cardiomyopathy. This report highlights a rare congenital anomalous origin of the coronary arteries associated with a high risk of SCD, particularly in young athletes.