Title:Narrative Review of Anomalous Origin of Coronary Arteries: Pathophysiology,
Management, and Treatment
Volume: 19
Issue: 6
Author(s): Sai Gautham Kanagala*, Vasu Gupta, Garrett V Dunn, Harmanjit Kaur, Farid Zieneddine, Rohit Jain and Nikita Garg
Affiliation:
- Osmania Medical College, Hyderabad, Telangana 500095, India
Keywords:
Coronary artery anomalies, sudden cardiac death, left aortic sinus, right coronary sinus, the anomalous aortic origin of the coronary artery, anomalous coronary arteries from the pulmonary artery
Abstract: Coronary artery anomalies (CAA) are a diverse group of congenital anomalies and are
the second most common cause of sudden cardiac death in the young population after Hypertrophic
Cardiomyopathy (HCM). Symptoms range from chest pain, syncope, or sudden cardiac arrest to
completely asymptomatic. The prevalence of congenital coronary artery anomalies in the general
population is estimated to be between 1% and 2%. CAA often gets underdiagnosed due to the lack
of knowledge of the disease process. Approximately 5% of patients with acute myocardial infarction
do not have atherosclerotic coronary artery disease or luminal narrowing due to other causes.
Congenital coronary artery anomalies account for 50-60% of this 5% of patients. Most patients are
asymptomatic for most of their lives, and chest pain is the most common symptom in symptomatic
patients when referred for coronary angiography, typically when the diagnosis is typically made.
The malignant coronary artery is a rare presentation of a coronary anomaly when associated with
atherosclerotic coronary artery disease or valvular heart disease. Patients with symptoms of an abnormal
coronary artery origin will receive medical treatment/observation, exercise restriction, coronary
angioplasty with stent deployment, or surgical repair.
