title: Coronary Artery Anomalies: When You Need to Worry.
abstract: There is a broad spectrum of coronary artery anomalies that cardiologists may encounter either incidentally or during evaluation for cardiac symptoms. These anomalies include anomalous coronary arteries arising from the opposite sinus of Valsalva (ACAOS), coronary fistulae, and coronary artery aneurysms. This manuscript outlines the unique features, diagnostic characteristics, and treatment considerations for these lesions.
  
  
  
  Intravenous ultrasound (IVUS), computed tomographic angiography (CTA), and magnetic resonance imaging (MRI) are becoming more sophisticated and will be increasingly used to facilitate the optimal treatment approach for coronary anomalies. There are a wide variety of coronary artery anomalies and their clinical ramifications range from benign to potentially fatal. Coronary anomalies often have complex anatomy and require advanced imaging modalities for comprehensive characterization. Due to the heterogeneity in lesion characteristics and outcomes, physicians should consider clinical and imaging features to create individualized management plans, along with referral to adult congenital heart disease centers.
authors.affiliation: Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA. ajar.kochar@duke.edu.|, 2400 Pratt Street, Durham, NC, 27705, USA. ajar.kochar@duke.edu.
authors.forename: Ajar
authors.initials: A
authors.lastname: Kochar
authors.affiliation: Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Kiefer
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000639:trends; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000473:pathology; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011379:Prognosis; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
keywords: Anomalous coronary artery arising from the opposite sinus (ACAOS); Congenital heart disease; Coronary anomaly; Coronary artery aneurysm (CAA); Coronary fistula; Sudden cardiac death