Abstract
Coronary anomalies comprise a diverse group of malformations, some of them asymptomatic with a benign course, and the others related to symptoms as chest pain and sudden death. Such anomalies may be classified as follows: 1) anomalies of origination and course; 2) anomalies of intrinsic coronary arterial anatomy; 3) anomalies of coronary termination. The origin and the proximal course of anomalous coronary arteries are the main prognostic factors, and interarterial course or a coronary artery is considered to be malignant due its association with increased risk of sudden death. Coronary computed tomography angiography has become the reference method for such an assessment as it detects not only anomalies in origination of these arteries, but also its course in relation to other mediastinal structures, which plays a relevant role in the definition of the therapeutic management. Finally, it is essential for radiologists to recognize and characterize such anomalies.
Highlights
Coronary anomalies can be found in 0.3% to 5.6% of the population(1,2)
A single coronary artery originates from a single aortic root ostium. This is an extremely rare anomaly (0.0024% to 0.044% of the population) and may present with the pattern of a main trunk bifurcating into right coronary and left coronary trunk, one coronary artery originating as a branch from another with normal origin, or not following the habitual distribution of the coronary anatomy(2) (Figure 11)
Transesophageal echocardiography may be useful in the characterization of coronary arteries origination and proximal course(9), but few reports are found in the literature in addition to fact that this is a semi-invasive method, not capable of demonstrating the entire pathway of such vessels(13,14)
Summary
Coronary anomalies can be found in 0.3% to 5.6% of the population(1,2). In spite of being less frequent as compared with acquired coronary diseases, congenital coronary artery anomalies are associated with morbidity and early mortality in young adults. It is estimated to be the second most frequent cause of sudden death of cardiovascular origin among athletes, occurring between 12.2% and 17.2% in Europe and in the United States(4–7). 1. Titular Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Member of the Society of Cardiovascular Computed Tomography, MD, Radiologist, Hospital Santa Luzia and Hospital do Coração do Brasil (Rede D’Or São Luiz), Brasília, DF, Brazil. 2. Titular Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Member of the Society of Cardiovascular Computed Tomography, MD, Radiologist, Hospital Santa Luzia, Hospital do Coração do Brasil (Rede D’Or São Luiz) and Groups of Radiological Images LifeScan and Padrão Imagens, Brasília, DF, Brazil. 3. Titular Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), MD, Radiologist, Hospital Santa Luzia and Hospital do Coração do Brasil (Rede D’Or São Luiz), Brasília, DF, Brazil. The present review approaches classification, main types, diagnostic methods and treatment of coronary artery anomalies, with emphasis on the condition subgroup with greater clinical repercussion: anomalies of origination and course
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
