CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 3, May/June 2011
AFRICA
141
Abstract
Congenital coronary sinus anomalies are unusual and they
rarely coexist with accessory atrio-ventricular pathways.
These anomalies are generally asymptomatic; however they
can cause difficulty in mapping. The association between
accessory pathway and coronary sinus anomalies may suggest
an embryological link. Here, we report on a male patient with
an accessory conducting pathway in the coronary sinus, lead-
ing to Wolff–Parkinson–White (WPW) syndrome.
Keywords:
coronary sinus, aberrant pathway, WPW syndrome
Submitted 26/3/10, accepted 22/4/10
Cardiovasc J Afr
2011;
22
: 141–143
DOI: CVJ-21.024
The presence of an accessory pathway is rarely associated with
cardiac abnormalities; the most frequent being Ebstein’s anoma-
ly.
1
Radio-frequency catheter ablation has been successfully used
in the treatment of accessory pathways for patients with coexist-
ent congenital heart disease,
2,3
however an abnormal coronary
sinus can cause difficulty in the mapping of these pathways.
We report on a case of an accessory pathway associated with
a diverticulum inserting into the proximal coronary sinus, which
was successfully ablated in the neck of the diverticulum.
Case report
A 27-year-old otherwise healthy male presented in the emer-
gency room after an episode of witnessed new-onset seizure.
The seizure was self-limiting and by the time the patient arrived,
he was alert, awake and asymptomatic. He denied any personal
or family history of seizures. His vital signs were stable and the
Case Reports
Aberrant pathway in an anomaly: pre-excitation
syndrome in association with coronary sinus aneurysm
F AZIZ, R KANAL, S BUTT, S PENUPOLU, A AMEEN
Fig. 1. WPW pattern on ECG.
Department of Internal Medicine, Jersey City Medical
Center, New Jersey, USA
F AZIZ, MD,
R KANAL, MD
S BUTT, MD
S PENUPOLU, MD
Department of Cardiology, UMDNJ, Newark, New Jersey,
USA
A AMEEN, MD
