Sudden death following a single coronary ostium located below an aortic valve leaflet: A rare autopsy case and review of the literature

Congenital coronary anomalies are rare but can cause serious cardiovascular events, including sudden death, in both young and old. A forensic autopsy of a 67-year-old woman found dead at her home revealed a single low coronary ostium located under an aortic valve leaflet, with an unobstructed coronary pathway. Myocardial scarring from a previous infarction was identified in the interventricular septum. This case illustrates the importance of recognising congenital coronary anomalies, even in elderly people, and evaluating their possible role in a sudden and unexplained deaths. A review of the literature of congenital coronary anomalies is provided to put this case into context.