In a 36-year old long-distance runner with a history of palpitations and presyncope, an episode of sudden cardiac death occurred during competitive mountain racing. Endless-loop Holter monitoring (A⇓) demonstrated rare episodes of nonsustained ventricular tachycardia, an episode of acceleration, and finally spontaneously terminating ventricular tachycardia followed by marked ST-segment alteration. Coronary angiography (B⇓ and C⇓) excluded coronary artery disease but demonstrated a tunneled epicardial coronary artery (myocardial bridges) (C⇓, arrows).
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.
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