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Postmortem studies of three ostensibly healthy persons whose unheralded death occurred incidental to strenuous exercise revealed an unobstructed but mural left anterior descending (LAD) artery, diminished vascularity to the posterior left ventricle and ventricular septum, and morphologic evidence of patchy, ischemic necrosis of the ventricular septum in different stages of healing. Although mural coronary arteries are considered a normal anatomic variant, our observations, coupled with reporteddoi:10.1161/01.cir.62.2.230 pmid:7397963 fatcat:xexp23khzfcnpovonnw46lfb4e