Echo diagnosis of ruptured aortic valve leaflet.

artery, and it has been suggested that these patients should be treated by bypass surgery. The mechanism for sudden death is not known. Theories include kinking of the anomalous artery2 and occlusion by a flap-like closure of the ostium as the aorta expands.3 However, sudden death, infarction, and ischemia may occur without regard to the course of the anomalous left coronary artery.4 In the past six years there have been nine cases of an anomalous left coronary artery from the right sinus of Valsalva or right coronary artery out of 7,893 adult cardiac catheterizations performed at Emory University Hospital and Grady Memorial Hospital. The course of the anomalous artery varied posterior to the aorta, anterior to the aorta, and anterior to the pulmonary artery. In only