Open AccessIdentifying, Characterizing, and Classifying Congenital Anomalies of the Coronary Arteries
Author(s) -
Jabi E. Shriki,
Jerold S. Shinbane,
Mollie A Rashid,
Antereas Hindoyan,
James G Withey,
Anthony DeFrance,
Mark J. Cunningham,
George R. Oliveira,
Bill H. Warren,
Alison Wilcox
Publication year - 2012
Publication title -
radiographics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.866
H-Index - 172
eISSN - 1527-1323
pISSN - 0271-5333
DOI - 10.1148/rg.322115097
Subject(s) - medicine , coronary arteries , cardiology , artery , pulmonary artery , atresia , right coronary artery , coronary artery anomaly , pulmonary atresia , left coronary artery , radiology , fistula , coronary angiography , myocardial infarction
The clinical manifestations of coronary artery anomalies vary in severity, with some anomalies causing severe symptoms and cardiovascular sequelae and others being benign. Cardiovascular computed tomography (CT) has emerged as the standard of reference for identification and characterization of coronary artery anomalies. Therefore, it is important for the reader of cardiovascular CT images to be thoroughly familiar with the spectrum of coronary artery anomalies. Hemodynamically significant anomalies include atresia, origin from the pulmonary artery, interarterial course, and congenital fistula. Non-hemodynamically significant anomalies include duplication; high origin; a prepulmonic, transseptal, or retroaortic course; shepherd's crook right coronary artery; and systemic termination. In general, coronary arteries with an interarterial course are associated with an increased risk of sudden cardiac death. Coronary artery anomalies that result in shunting, including congenital fistula and origin from the pulmonary artery, are also commonly symptomatic and may cause steal of blood from the myocardium. Radiologists should be familiar with each specific variant and its specific constellation of potential implications.