Mechanisms of myocardial ischemia inducing sudden cardiac death in athletes with anomalous coronary origin from the opposite sinus: Insights from a computational fluid dynamic study.

•In left coronary anomalous origin from the opposite sinus (L-ACAOS), the intramural course (IM) is supposed to be compressed during exercise.•The study confirmed that the IM is effectively compressed during exercise.•The rheological properties observed over the IM also propagated along the entire left coronary system, predisposing spasm and thrombosis in athletes.