title: Identifying, characterizing, and classifying congenital anomalies of the coronary arteries.
abstract: 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.
authors.affiliation: South Sound Radiology, 3417 Ensign Rd NE, Olympia, WA 98506, USA. jshriki@gmail.com
authors.forename: Jabi E
authors.initials: JE
authors.lastname: Shriki
authors.forename: Jerold S
authors.initials: JS
authors.lastname: Shinbane
authors.forename: Mollie A
authors.initials: MA
authors.lastname: Rashid
authors.forename: Antereas
authors.initials: A
authors.lastname: Hindoyan
authors.forename: James G
authors.initials: JG
authors.lastname: Withey
authors.forename: Anthony
authors.initials: A
authors.lastname: DeFrance
authors.forename: Mark
authors.initials: M
authors.lastname: Cunningham
authors.forename: George R
authors.initials: GR
authors.lastname: Oliveira
authors.forename: Bill H
authors.initials: BH
authors.lastname: Warren
authors.forename: Alison
authors.initials: A
authors.lastname: Wilcox
mesh_terms: D000328:Adult; D001159:Arterio-Arterial Fistula / Q000151:congenital / Q000000981:diagnostic imaging; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005402:Fistula / Q000151:congenital / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016157:Vascular Fistula / Q000151:congenital / Q000000981:diagnostic imaging; D055815:Young Adult