{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:26:44Z","timestamp":1765261604352,"version":"3.46.0"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Anomalous aortic origin of a coronary artery from the opposite sinus (AOCAOS) is a rare variety of coronary artery anomalies. Left main coronary artery (LMCA) arising from right coronary cusp (RCC) with a transseptal course is an uncommon variant that may not be as benign as previously thought. The coexistence of AOCAOS with dilated cardiomyopathy (DCM) is exceptionally rare and presents diagnostic and therapeutic challenges. Herein, we present a 43\u2010year\u2010old man with a history of Type 2 diabetes mellitus and chronic substance use who was admitted after successful resuscitation from pulseless ventricular tachycardia (VT). Initial workup revealed severely reduced left ventricular ejection fraction (LVEF) of 20% on echocardiography. Invasive coronary angiography demonstrated anomalous origin of the LMCA from the RCC. Cardiac magnetic resonance (CMR) confirmed the diagnosis of DCM with no evidence of fibrosis, and coronary computed tomography angiography (CCTA) delineated a transseptal course of the anomalous LMCA. The patient was managed medically for heart failure and underwent cardiac resynchronization therapy defibrillator (CRT\u2010D) implantation for primary prevention of sudden cardiac death. At 3\u2010month follow\u2010up, he showed significant clinical improvement. This case underscores the importance of a comprehensive diagnostic approach in sudden cardiac death survivors and highlights that transseptal AOCAOS may not be benign when associated with cardiomyopathy. Coronary CTA and CMR are essential tools for complete evaluation.<\/jats:p>","DOI":"10.1002\/ccr3.71408","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T08:34:38Z","timestamp":1762245278000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Middle\u2010Aged Man With Pulseless\n                    <scp>VT<\/scp>\n                    and Dual Pathology: Anomalous Left Main Coronary Artery From Right Coronary Cusp With Transseptal Course and Underlying Dilated Cardiomyopathy"],"prefix":"10.1002","volume":"13","author":[{"given":"Amir","family":"Heidari","sequence":"first","affiliation":[{"name":"Department of Cardiology, Imam Hossein Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enssieh","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fatemeh Zahra Hospital Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4866-2623","authenticated-orcid":false,"given":"Mehrdad","family":"Jafari Fesharaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5026-5101","authenticated-orcid":false,"given":"Golnaz","family":"Houshmand","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Reseach Centre Rajaie Cardiovascular Institute  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9719-2183","authenticated-orcid":false,"given":"Roghaye","family":"Ghiasvand\u2010Mohammadkhani","sequence":"additional","affiliation":[{"name":"Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa554"},{"issue":"1","key":"e_1_2_13_3_1","first-page":"153","article-title":"Anomalous Aortic Origin of the Left Coronary Artery","volume":"83","author":"Mrad S.","year":"2023","journal-title":"Medicina (B Aires)"},{"issue":"14","key":"e_1_2_13_4_1","first-page":"e698","article-title":"AHA\/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Stout K. 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V.","year":"2024","journal-title":"Pediatric Radiology"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050313X231200150"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43044-020-00093-x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.08.012"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1295602"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22147722"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.19102\/icrm.2023.14051"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28633"},{"issue":"4","key":"e_1_2_13_16_1","first-page":"258","article-title":"Left Ventricular Dysfunction: Neither a Matter of Atherosclerosis nor an Anomalous Originated Right Coronary Artery From Left Anterior Descending Artery","volume":"11","author":"Attar A.","year":"2015","journal-title":"ARYA Atherosclerosis"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810190113"},{"issue":"5","key":"e_1_2_13_18_1","first-page":"341","article-title":"Anomalous Origin of the Left Coronary Artery From the Right Sinus of Valsalva With Retro\u2010Aortic Path","volume":"43","author":"Alonso V. B.","year":"1990","journal-title":"Revista Espa\u00f1ola de Cardiolog\u00eda"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.11.013"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-018-0396-6"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T05:52:44Z","timestamp":1765259564000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ccr3.71408"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71408","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71408"}}