Congenital coronary artery anomalies

Mr Andrew Murphy and Radswiki et al.

Congenital coronary artery anomalies (CCAAs) are not common, found only in ~1% (range 0.1-2%) of patients 1,3.

The most important finding to look for is the "malignant" course of anomalous coronary artery, namely, does the artery run between big pulsating objects - RVOT and pulmonary artery on one side and aorta on the other. Exacerbated pulsations during or just after exercise can sometimes compress the coronary artery enough to cause severely diminished blood flow to myocardium, which can cause re-entry phenomenon in the myocardium and sudden cardiac death due to VF or sustained VT.

In most cases, it is the right coronary artery, which has such a "malignant" course, and it is young adults or even teenagers, who die because of this. It is estimated that around a quarter of sudden cardiac deaths in this population is caused by malignant coronary artery course.

Next thing to look for and which can cause anginal pain at exertion, is an intramural course of a coronary artery (known as myocardial bridging). Usually, it is the mid LAD, which has such a course. Describe location (LAD segment), length and depth of bridging in your report.

Of course, every anomalous coronary artery course should be described, if not for anything else, then for the interventional cardiologist, who should know about this 7.

Related pathology

A vast number of different coronary artery abnormalities have been described, and are discussed separately (see related articles). 

Congenital coronary artery anomalies
Thoracic anatomy
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Article information

rID: 12296
Systems: Cardiac, Vascular
Section: Anatomy
Synonyms or Alternate Spellings:
  • Congenital coronary artery anomaly
  • Congenital coronary arterial anomalies
  • Congenital coronary artery anomalies (CCAA)
  • CCAA
  • Congenital coronary artery abnormality
  • Congenital coronary artery abnormalities
  • Congenital coronary arterial abnormalities
  • Coronary artery anomalies (CAAs)
  • Coronary artery anomalies
  • Coronary artery anomaly
  • Congenital anomaly of the coronary arteries
  • Coronary artery variants

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Cases and figures

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    Cardiac CT, sagit...
    Case 1: anomalous right coronary artery
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    Atypical origin a...
    Case 2: atypical origin and course of the left coronary
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    Atypical origin a...
    Case 2: atypical origin and course of the left coronary
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    Case 3: seperate origin of RCA and conus artery
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    Case 4: RCA aneurysm
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    Case 5: anomalous course of circumflex artery
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    Case 6: single coronary artery
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    Case 7: separate origins of the LCx and LAD
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