Case presentation A 53-year-old woman, previously fit and well, presented with a history of exertional chest discomfort radiating to left breast and left arm, with risk factors for coronary artery disease (hypertension and smoking). Figure 2. [bjcardio.co.uk]

Most symptomatic patients present at a young age. The coronary artery may pass between the aorta and the main pulmonary artery, representing a so-called interarterial course. [radiopaedia.org]

In the present case the right and left coronary arteries originated from the left posterior aortic sinus as a rare variation. [pulsus.com]

The reconstructed pulmonary artery (PA) does not present any narrowing. [jove.com]

Others can present with chest pain, syncope, or sudden cardiac death. [oatext.com]

• Asymptomatic

  Many patients with that type of abnormality are asymptomatic before the fatal event. [read.nxtbook.com]

  However, individuals may be asymptomatic, with the first presentation being sudden death. 1,25,30 One study showed that around 50% of patients who had this anomaly and died suddenly after physical exercise were asymptomatic. 13 The physical exam is most [revportcardiol.org]

  Diagnosis The symptoms vary from life-threatening events (e.g., myocardial infarction, cardiac syncope and ventricular dysrhythmia) to atrial or ventricular volume overload and asymptomatic courses. [infona.pl]

  The majority (approximately 80%) of anomalous coronary artery courses are benign and asymptomatic. However, on rare occasions, it can result in ischemia, arrhythmias or sudden death. Most symptomatic patients present at a young age. [radiopaedia.org]

  As she was asymptomatic with only a small area of reversible ischaemia and the LAD (culprit vessel) was hypoplastic, it was not attractive for any sort of intervention or surgery. It was decided that medical management was the best strategy for her. [bjcardio.co.uk]

• Congestive Heart Failure

  Most patients in whom the origin of the left coronary artery (LCA) is the main pulmonary artery manifest congestive heart failure and myocardial ischaemia in the first four months of life. 2 This coronary anomaly is rarely seen in adults. [ecrjournal.com]

  This anomaly is responsible for 18% of all cases of congestive heart failure in children younger than 2 years. [thehealthscience.com]

  Myocardial ischemia, ventricular fibrillation, syncope, congestive heart failure and sudden cardiac death are associated with this anomaly. [cathlabdigest.com]

  Usual presentation with; Sudden death Congestive heart failure Angina pectoris Myocardial infarction All Coronary Arteries from Pulmonary Artery Both right and left coronary arteries, or a single coronary artery, may come from the pulmonary trunk. [wikidoc.org]

  The fourth patient, a 64 year old woman, died of chronic congestive heart failure 1 year after an acute myocardial infarction. She had insignificant coronary atherosclerosis. [rwjms1.umdnj.edu]

• Pulmonary Valve Stenosis

  valves stenosis insufficiency absence tricuspid valves stenosis atresia Ebstein's anomaly Hypoplastic right heart syndrome Uhl anomaly Left aortic valves stenosis insufficiency bicuspid mitral valves stenosis regurgitation Hypoplastic left heart syndrome [en.wikipedia.org]

  […] and tricuspid valves pulmonary valves ( stenosis, insufficiency ) - tricuspid valves ( stenosis, atresia ) - Ebstein's anomaly Left: aortic and mitral valves aortic valves ( stenosis, insufficiency, bicuspid ) - mitral valves ( stenosis, regurgitation [wikidoc.org]

  A host of congenital cardiac anomalies has been reported in association with QAV which include, ventricular or atrial septal defect (VSD, ASD) [ 15, 16 ], pulmonary valve stenosis, sub-aortic fibromuscular stenosis [ 17 ], supra-valvular stenosis with [omicsonline.org]

• Surgical Procedure

  Master cardiac surgery with the Gold Standard for Cardiac Surgery - the most definitive and clinically comprehensive resource on cardiologic procedures including latest alternate and minimally invasive surgical procedures [books.google.com]

  Therefore, when patients are identified as having this anomaly, aggressive surgical management is often recommended.14 There are currently two surgical procedures for the correction of this anomaly: re-implantation and coronary artery bypass grafting [cathlabdigest.com]

  Although coronary artery bypass graft guidelines acknowledge that PCI has been used in adults with anomalous coronary arteries (71), a recent American College of Cardiology/American Heart Association Task Force recommends, “surgical procedures are the [onlinejacc.org]

• Heart Disease

  Failure and Coronary Heart Disease 533 Surgical Treatment of Advanced Heart Failure 561 Kawasaki Disease 580 Percutaneous Coronary Intervention and the Various Coronary Artery Disease Syndromes 597 The Electrocardiogram in Coronary Artery Disease 204 [books.google.com]

  Alonso-Pulpon Springer, 27 nov. 2014 - 362 páginas The objective of this Atlas is to contribute to the knowledge of morphological findings of the main cardiovascular diseases among the various specialists who deal with people affected of heart diseases [books.google.es]

  […] of Adults With Congenital Heart Disease). [wikidoc.org]

• Heart Failure

  Failure and Coronary Heart Disease 533 Surgical Treatment of Advanced Heart Failure 561 Kawasaki Disease 580 Percutaneous Coronary Intervention and the Various Coronary Artery Disease Syndromes 597 The Electrocardiogram in Coronary Artery Disease 204 [books.google.com]

  Artery These patients may present with ischaemic symptoms or symptoms of heart failure from an ischaemic cardiomyopathy in infancy. [ecrjournal.com]

  This anomaly is responsible for 18% of all cases of congestive heart failure in children younger than 2 years. [thehealthscience.com]

• Irritability

  Alarms • • • • • • • • • • • • Irritability Poor Feeding Slowed Or Poor Growth And Development Dyspnea (Difficulty Breathing) Wheezing Diaphoresis (Sweating) /Syncope Grayish Skin Color In Conjunction With Other Symptoms Periods Of Pallor (Pale Skin) [slideshare.net]

  Infants typically have feeding problems, irritability, diaphoresis, tachypnea, tachycardia, and sometimes chest pain due to myocardial ischemia. [revportcardiol.org]

Evaluation of Vulnerable Atherosclerotic Plaques 409 Medical Treatment of Stable Angina 421 Medical Treatment of Unstable Angina and Acute NonSTElevation Myocardial Infarction 461 Treatment of Acute STElevation Myocardial Infarction 505 Medical Treatment [books.google.com]

[…] and prognosis Treatment of anomalous coronary arteries is controversial. [radiopaedia.org]

Surgical treatment of coronary artery anomalies: report of a 37 ½-year experience at the Texas Heart Institute. Tex Heart Inst J 2002; 29 :299–307. [bjcardio.co.uk]

The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]

If diagnosed antemortem, surgery is the treatment of choice in most cases Takeuchi procedure: used to correct the infantile form of anomalous origin of coronaries by creating a communication between the aorta and the left coronary ostium through the [pathologyoutlines.com]

[…] opposite sinus 4,5 : 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 [radiopaedia.org]

Due to the severity of this patient’s anomaly, the best surgical decision, with the best prognosis, is CABG. [cathlabdigest.com]

Coronary bypass surgery does not carry a higher mortality, and further longitudinal studies will be required to determine the influence on long-term prognosis. Fig. 1. [kjim.org]

PMID: 16118540 See all (1) Prognosis Cardiovascular magnetic resonance of anomalous coronary arteries. Varghese A, Keegan J, Pennell DJ Coron Artery Dis 2005 Sep;16(6):355-64. [ncbi.nlm.nih.gov]

This affects the treatment and prognosis of the underlying disease. 7,11 The real incidence of CCAAs in the general population remains unclear, ranging from 0.2% to 5.6%. [revportcardiol.org]

Clefts have a complex etiology and likely result from an interaction between environmental and genetic factors as well [ 43 ]. [omicsonline.org]

[…] pressure by maintaining PVR and myocardial contractility. 3 A ductus arteriosus maintained with prostaglandin may be the only supply of oxygenated blood to the coronaries. 1 The baby depicted in these images had elevated pulmonary pressures of unclear etiology [anesthesiology.pubs.asahq.org]

Isolated left coronary ostial stenosis is a rare condition of unknown etiology. [kjim.org]

Information Search database Search term Limits Advanced Help Full Report Format Full Report Summary (Text) Summary (XML) Send to: Choose Destination File Clipboard Collections MedGen UID: 833385 • Concept ID: CN229303 • Finding Orphanet: ORPHA99089 Etiology [ncbi.nlm.nih.gov]

These anomalies have different clinical and anatomical presentations that still need more studies to know the prevalence, etiology or risk factors and how to screen for such anomalies. [oatext.com]

"rarely" encountered in the general population Epidemiology Coronary anomalies affect 1% of the general population Necropsies yield an even lower incidence (0.3%) According to the Sudden Death Committee of the American Heart Association, coronary anomalies [pathologyoutlines.com]

Kardos A, Babai L, Rudas L et al: Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. Cathet Cardiovasc Diagn. 1997 Nov;42(3): 270-275. 7. [ispub.com]

Hypoplastic coronary arteries have small luminal diameter (usually Epidemiology Frequency United StatesCoronary artery anomalies are observed in 0.3-1.3% of patients undergoing diagnostic coronary angiography, in approximately 1% of routine autopsy examinations [thehealthscience.com]

Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. Cathet Cardiovasc Diagn. 1997;42:270-275. Lipton MJ, Barry WH, Obrez I, et al. [read.nxtbook.com]

Epidemiologic studies suggest that genetic factors are the predominant cause of congenital heart disease (CHD) although environmental exposures are also relevant. [omicsonline.org]

Letture consigliate Cademartiri F, Runza G, Luccichenti G et al (2006) Coronary artery anomalies: incidence, pathophysiology, clinical relevance and role of diagnostic imaging. [link.springer.com]

Techniques 253 Clinical Cardiac Positron Emission Tomography 263 Magnetic Resonance Imaging of the Myocardium Coronary Arteries and Anomalous Origin of Coronary Arteries 283 Computed Tomograph Cardiovascular Imaging 338 Coronary Heart Disease Syndromes Pathophysiology [books.google.com]

[…] of deaths in athletes ( Circulation 1996;94:850 ) Burke et. al. reported that in 14 to 40 year olds, coronary anomalies are involved in 12% of sports related sudden cardiac deaths versus 1.2% of non sports related deaths ( Am Heart J 1991;121:568 ) Pathophysiology [pathologyoutlines.com]

Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation, 105 (2002), pp. 2449-2454 [20.] P. Angelini. Coronary artery anomalies: an entity in search of an identity. Circulation, 115 (2007), pp. 1296-1305 Copyright © 2010. [elsevier.es]

Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 2002; 105 :2449–54. http://dx.doi.org/10.1161/01.CIR.0000016175.49835.57 3. Michael H. Congenital anomalies of the coronary arteries. [bjcardio.co.uk]

Children’s heart conditions can’t be prevented, but a lot can be done to improve and often completely repair their hearts at any age. [nemours.org]

Coronary Artery Disease 657 Coronary Artery Bypass Surgery and Percutaneous Coronary Revascularization Impact on Morbidity and Mortality in Patients with Coronary Artery ... 683 Cardiovascular Genetics Focus on Genetics of Coronary Artery Disease 727 Preventive [books.google.com]

Preventing heart disease is the key. Doctors are also studying innovative ways to treat heart disease, including: Angiogenesis. [webmd.com]

These coronary anomalies can be detected in early stages of life, by developing the markers for identification and simultaneous surgery for the anomaly may be the best way to prevent sudden death [ 11 ]. References Datta AK. [pulsus.com]

Surgical repair of the coronary anomaly may be considered as the best way to prevent a future fatal cardiac event. Correspondence to Gavrielatos Gerasimos, M.D. [ispub.com]