Clinical FeaturesMost of these anomalous arteries do not cause myocardial ischemia, particularly if the anomalous branch does notpass between the aorta and the right ventricular infundibulum. Even those that do run between these structuresdo not always lead to sudden or premature death. However, this is the group that accounts for symptoms andsudden death in children, adolescents, and young adults. Although the first sign of the anomaly is sometimessudden death or a fatal myocardial infarction, in many of these patients, there may be a history of syncope or
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