Overview of coronary artery variants, aberrations and anomalies
Open Access
- 26 October 2018
- journal article
- review article
- Published by Baishideng Publishing Group Inc. in World Journal of Cardiology
- Vol. 10 (10), 127-140
- https://doi.org/10.4330/wjc.v10.i10.127
Abstract
Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The rapid advancement of imaging techniques, including computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography, have provided us with a wealth of new information on the subject. Anomalous origin of a coronary artery from the contralateral sinus is the anomaly most frequently associated with sudden cardiac death, in particular if the anomalous coronary artery has a course between the aorta and the pulmonary artery. However, other coronary anomalies, like anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae, have also been implicated in cases of sudden cardiac death. Patients are usually asymptomatic, and in most of the cases, coronary anomalies are discovered incidentally during coronary angiography or on autopsy following sudden cardiac death. However, in some cases, symptoms like angina, syncope, heart failure and myocardial infarction may occur. The aims of this article are to present a brief overview of the diverse coronary variants and anomalies, focusing especially on anatomical features, clinical manifestations, risk of sudden cardiac death and pathophysiologic mechanism of symptoms, as well as to provide valuable information regarding diagnostic workup, follow-up, therapeutic choices and timing of surgical treatment.Keywords
This publication has 76 references indexed in Scilit:
- An unusual pattern of three major components of the cardiovascular system: multimodality imaging and review of the literatureJournal of Cardiothoracic Surgery, 2013
- A rare case of anomalous origin of the left main coronary artery in an adult patientJournal of Cardiothoracic Surgery, 2013
- Long-Term Outcome and Impact of Surgery on Adults With Coronary Arteries Originating From the Opposite Coronary CuspCirculation, 2011
- Myocardial bridging and sudden death in hypertrophic cardiomyopathy: Salome drops another veilEuropean Heart Journal, 2009
- Myocardial bridging, a frequent component of the hypertrophic cardiomyopathy phenotype, lacks systematic association with sudden cardiac deathEuropean Heart Journal, 2009
- Newer concepts for imaging anomalous aortic origin of the coronary arteries in adultsCatheterization and Cardiovascular Interventions, 2007
- Double Right Coronary Artery: Review of LiteratureThe International Journal of Cardiovascular Imaging, 2005
- Sports-related and non-sports-related sudden cardiac death in young adultsAmerican Heart Journal, 1991
- Right Ventricular Cardiomyopathy and Sudden Death in Young PeopleThe New England Journal of Medicine, 1988
- Anomalies of the Coronary Arteries and their Clinical SignificanceCirculation, 1956