Anomalous course of coronary arteries
Updates to Article Attributes
Anomalous course of a coronary artery is a type of congenital coronary artery anomaly. It may represent a benign and incidental finding incidental finding, but can also be a malignant malignant course predisposing patients to life life-threatening myocardial ischaemia or arrhythmias, depending on where the artery runs.
Clinical presentation
The majority of anomalous coronary artery courses, approximately 80%, are benign and are asymptomatic. However, on rare occasions, it can result in ischaemia, arrhythmias or sudden death. Most symptomatic patients are young.
Pathology
The coronary artery may pass between pass between the aorta and the main pulmonary artery, representing a so a so-called inter-arterial course. It may be associated with a "slit-like" orifice in which an acute angle course at the ostium is more prone to occlusion. During physical activity, the artery may be compressed, and the flow within it may be compromised compromised. The presence of a "slit-like" orifice or intramural course of the coronary artery within the aortic wall is is more predictive of adverse outcome than the inter-arterial course alone.
There are four common courses courses for an anomalous coronary artery arising from the opposite sinus4,5:
- malignant course
- interarterial (i.e. between the aorta and the pulmonary artery): this is the most dangerous as it carries a high risk of sudden cardiac death
- benign course
- retroaortic
- prepulmonic
- septal (subpulmonic)
Treatment and prognosis
Treatment of anomalous coronary arteries is is controversial. Mainly patients with a benign course rarely need surgical surgical treatment. Symptomatic patients with an inter-arterial course may require surgical surgical "re-implantation" of the anomalous coronary artery or "de-roofing" if an intramural course is present.
-<p><strong>Anomalous course of a coronary artery</strong> is a type of <a href="/articles/congenital-coronary-artery-anomalies">congenital coronary artery anomaly</a>. It may represent a benign and incidental finding, but can also be a malignant course predisposing patients to life-threatening myocardial ischaemia or arrhythmias, depending on where the artery runs. </p><h4>Clinical presentation</h4><p>The majority of anomalous coronary artery courses, approximately 80%, are benign and are asymptomatic. However, on rare occasions, it can result in ischaemia, arrhythmias or sudden death. Most symptomatic patients are young.</p><h4>Pathology</h4><p>The coronary artery may pass between the aorta and the main pulmonary artery, representing a so-called inter-arterial course. It may be associated with a "slit-like" orifice in which an acute angle course at the ostium is more prone to occlusion. During physical activity, the artery may be compressed, and the flow within it may be compromised. The presence of a "slit-like" orifice or intramural course of the coronary artery within the aortic wall is more predictive of adverse outcome than the inter-arterial course alone.</p><p>There are four common courses for an anomalous coronary artery arising from the opposite sinus <sup>4,5</sup>:</p><ul>- +<p><strong>Anomalous course of a coronary artery</strong> is a type of <a href="/articles/congenital-coronary-artery-anomalies">congenital coronary artery anomaly</a>. It may represent a benign and incidental finding, but can also be a malignant course predisposing patients to life-threatening myocardial ischaemia or arrhythmias, depending on where the artery runs. </p><h4>Clinical presentation</h4><p>The majority of anomalous coronary artery courses, approximately 80%, are benign and are asymptomatic. However, on rare occasions, it can result in ischaemia, arrhythmias or sudden death. Most symptomatic patients are young.</p><h4>Pathology</h4><p>The coronary artery may pass between the aorta and the main pulmonary artery, representing a so-called inter-arterial course. It may be associated with a "slit-like" orifice in which an acute angle course at the ostium is more prone to occlusion. During physical activity, the artery may be compressed, and the flow within it may be compromised. The presence of a "slit-like" orifice or intramural course of the coronary artery within the aortic wall is more predictive of adverse outcome than the inter-arterial course alone.</p><p>There are four common courses for an anomalous coronary artery arising from the opposite sinus <sup>4,5</sup>:</p><ul>
-</ul><h4>Treatment and prognosis</h4><p>Treatment of anomalous coronary arteries is controversial. Mainly patients with a benign course rarely need surgical treatment. Symptomatic patients with an inter-arterial course may require surgical "re-implantation" of the anomalous coronary artery or "de-roofing" if an intramural course is present.</p>- +</ul><h4>Treatment and prognosis</h4><p>Treatment of anomalous coronary arteries is controversial. Mainly patients with a benign course rarely need surgical treatment. Symptomatic patients with an inter-arterial course may require surgical "re-implantation" of the anomalous coronary artery or "de-roofing" if an intramural course is present.</p>
Systems changed:
- Vascular
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