Congenital anomalies of the coronary circulation: Difference between revisions

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#REDIRECT [[Coronary artery anomalies]]
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'''Editors in Chief:''' Eli Gelfand, M.D. and C. Michael Gibson, M.S., M.D.
 
'''Associate Editors in Chief:''' Arnoldas Giedrimas, M.D.
 
==Overview==
The diagnosis of a congenital anomaly in the coronary circulation is often may on coronary angiography, CMR, or CT angiography <ref> Angelini P: Normal and anomalous coronary arteries: definitions and classification. Am Heart J 1989 Feb; 117(2): 418-34.</ref> <ref> Angelini P, Fairchild VD, eds: Coronary Artery Anomalies: A Comprehensive Approach. Lippincott, Williams & Wilkins; 1999. </ref>. Stress testing can be used to evaluate the functional risk of ischemia.
 
==Specific Anomalies==
===Anomalous Origin of the [[Circumflex Artery]]===
*The origin is from the posterior [[aortic sinus]]
*Retroaortic course
*Posterior AV groove course
 
===Anomalous [[Right Coronary Artery]]===
*Origin from left [[sinus of Valsalva]]
*Origin from the [[left anterior descending artery]] ([[LAD]])
**Can lead to MI, [[sudden cardiac death]]
 
===Atypical origin of the Left Coronary Artery===
The left coronary artery originates from the [[pulmonary artery]] in the [[Bland-White-Garland syndrome]]. This results in:
*Low perfusion pressure
*[[Hypoxemia]]
*May lead to coronary artery steal, and left to right shunt
 
===Atypical origin of the [[Left Anterior Descending Artery]] ([[LAD]])===
*Aortic root
*Right [[sinus of Valsalva]], [[Right Coronary Artery]] ([[RCA]])
**LAD course between aorta and PA may result in compression with exercise
**This variant is associated with [[Tetralogy of Fallot]]
 
===Atypical origin of LCx===
**Aortic root
**R sinus of Valsalva, RCA
***course posterior to L ventricle, generally benign
 
===[[Tetralogy of Fallot]]===
**LAD may originate from RCA, courses across pulmonary outflow tract
 
===Other Cogential Heart Diseases in which There Can Be An Anomalous Origin of the Coronary Arteries===
*[[Transposition of the great arteries]]
*[[Double outlet right ventricle]]
*[[Truncus arteriosus]]
 
===[[Myocardial Bridge]]===
 
==References:==
{{reflist|2}}
 
==Additional Reading==
 
* Moss and Adams' Heart Disease in Infants, Children, and Adolescents Hugh D. Allen, Arthur J. Moss, David J. Driscoll, Forrest H. Adams, Timothy F. Feltes, Robert E. Shaddy, 2007 ISBN 0781786843
* Hurst's the Heart, Fuster V, 12th ed. 2008, ISBN 978-0-07-149928-6
* Willerson JT, Cardiovascular Medicine, 3rd ed., 2007, ISBN 978-1-84628-188-4
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{{Congenital malformations and deformations of circulatory system}}
{{Circulatory system pathology}}
 
 
[[Category:Cardiology]]
 
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Latest revision as of 16:43, 3 December 2013