Congenital anomalies of the coronary circulation: Difference between revisions

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#REDIRECT [[Coronary artery anomalies]]
 
'''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}}
 
{{Coronary Angiography}}
 
[[Category:Cardiology]]
[[Category:Angiopedia]]
 
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Latest revision as of 16:43, 3 December 2013