title: Coronary CTA assessment of coronary anomalies.
abstract: Coronary anomalies occur in <1% of the general population and can range from a benign incidental finding to the cause of sudden cardiac death. The coronary anomalies are classified here according to the traditional grouping into those of origin and course, intrinsic arterial anatomy, and termination. Classic coronary anomalies of origin and course include those in which a coronary artery originates from the contralateral aortic sinus or the pulmonary artery with anomalous course. Single coronary artery anomalies, in which single coronary artery branches to supply the entire coronary tree, are also included in this category. Anomalies of intrinsic arterial anatomy are a broad class that includes myocardial bridges, coronary ectasia and aneurysms, subendocardial coursing arteries, and coronary artery duplication. Coronary anomalies of termination are those in which a coronary artery terminates in a fistulous connection to a great vessel or cardiac chamber. In the case of those anomalies associated with a risk of sudden cardiac death, the relevant imaging features on CT angiography (CTA) associated with poorer prognosis are reviewed. Recent guidelines and appropriateness criteria favor the use of coronary CTA for the evaluation of coronary anomalies. Although invasive angiography has historically been used to diagnose coronary anomalies, multidetector CT imaging techniques have now become an accurate noninvasive alternative. Cardiac CTA provides excellent spatial and temporal resolution, allowing accurate anatomical assessment of these anomalies.
authors.affiliation: Temple University School of Medicine, Division of Cardiology, Pennsylvania, PA, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Pursnani
authors.forename: Jill E
authors.initials: JE
authors.lastname: Jacobs
authors.forename: Farhood
authors.initials: F
authors.lastname: Saremi
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Levisman
authors.forename: Amgad N
authors.initials: AN
authors.lastname: Makaryus
authors.forename: Carlos
authors.initials: C
authors.lastname: Capuñay
authors.forename: Ian S
authors.initials: IS
authors.lastname: Rogers
authors.forename: Christoph
authors.initials: C
authors.lastname: Wald
authors.forename: Shah
authors.initials: S
authors.lastname: Azmoon
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Stathopoulos
authors.forename: Monvadi B
authors.initials: MB
authors.lastname: Srichai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult