Coronary Artery Connection Abnormalities: About Four Cases

Abstract

Coronary artery connection abnormalities are a diverse group of congenital disorders whose manifestations and pathological mechanisms are highly variable. This abnormalities are undergoing significant changes in terms of description, morphogenesis, clinical presentation, diagnostic assessment, prognosis and treatment. It is an important entity because of its clinical impact, the risk of sudden death, its prevalence and its practical management. The rapid development of imaging techniques such as computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography has brought a lot of new information on the issue. It is most often associated with sudden cardiac mortality if the abnormal connection of a coronary artery from the controlateral sinus, especially if it passes between the aorta and the pulmonary artery. Patients are often asymptomatic and coronary abnormalities are incidentally identified during coronary angiography or autopsy after sudden cardiac death in the majority of cases. Symptoms such as angina pectoris, syncope, heart failure and myocardial infarction can occur under certain circumstances. The purpose of this article is to provide a brief overview of the various variants of this disease, focusing on some clinical manifestations, the risk of sudden cardiac death and the physiopathological mechanism of symptoms, as well as valuable information on diagnostic assessment and treatment options.