(BMJ 2006;332:1139-41) I do wish I could keep all those rarities that I ought to be aware of "just in case" firmly stuck in my head, ready to recall in the appropriate consultations. You know, those things that if we missed them might be life threating, those things that the regional specialist sees once or twice a year, that I might never see, or might see once and be for ever worried about missing it (again).
Kumpf et al report on the anomalous left coronary artery in (2) young athletes with syncope. 3 Coronary arteries arise from the 3 aortic sinuses in the normal young athlete, but in some people, the left coronary can arise from the right aortic sinus. This can lead to syncope. If recognised it can be treated by re-siting the anomalous artery. If not recognised it can lead to fatal arrhythmia. Even a normal exercise test is not of value in excluding the diagnosis - apparently it requires an echocardiogram, done by someone who has the condition in mind and is looking for it.
What is required here is a website of rare medical conditions that if missed might prove fatal - access might need to be restricted.
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