[Another case of juvenile sudden death caused by anomalous origin of the right coronary from the left anterior sinus of Valsalva].

A second case of sudden death during athletic activity, due to anomalous origin of the right coronary artery from the left anterior sinus of Valsalva, is presented. Post-mortem examination disclosed widespread myocardiosclerosis involving the subepicardial layers of the posterior wall of the left ventricle. Submaximal exercise testing had been performed to evaluate the presence of a ventricular extrasystole on a basal ECG, but no significant ischemic alterations of the ST tract had been detected. This case proposes once again the uncertainties regarding the diagnostic sensitivity of the protocols for competitive sport fitness in revealing latent chronic ischemia.