Coronary artery anomalies

Abstract

Isolated congenital coronary artery anomalies have been reported in approximately 1.3 % (range 0.2-5.6 %) of patients undergoing x-ray coronary angiography (Yamanaka and Hobbs, Cathet Cardiovasc Diagn 21:28-40, 1990; Click et al. J Am Coll Cardiol 13:531-537, 1989; Baltaxe and Wixson, Radiology 122:47-52, 1977; Engel et al., Cathet Cardiovasc Diagn 1:157-169, 1975) and approximately 0.3 % of patients at autopsy (Alexander and Griffith, Circulation 14:800-805, 1956). About 80 % of coronary anomalies are considered benign without significant clinical sequelae, with the remaining 20 % potentially responsible for significant symptoms such as myocardial ischemia and sudden death (Yamanaka and Hobbs, Cathet Cardiovasc Diagn 21:28-40, 1990). The ability to identify coronary artery anomalies and define their anatomic course is important to further evaluate patients in whom a coronary anomaly is suspected. Noninvasive imaging has been the preferred way to evaluate patients with a suspected coronary artery anomaly, and it is important for physicians to recognize and understand the clinical and imaging features of the most commonly encountered coronary artery anomalies.