"Patient management is still controversial, with limited evidence-base 9, and depends on symptoms, the affected coronary artery and the anomalous course. Prepulmonic and retroaortic courses are considered benign and not of haemodynamic relevance. An interarterial and especially an intramural course is considered malignant and is associated with an increased risk of sudden cardiac death 1-3,6."
"Anomalous origin of the coronary artery arising from the opposite sinus (ACAOS) is a narrower definition and refers to either the left coronary artery arising from the right coronary sinus or vice versa."
"Anomalous origin of the coronary artery arising from the opposite sinus (ACAOS) is a narrower definition and refers to either the left coronary artery arising from the right coronary sinus or vice versa."
"Coronary MRA can be alternatively used for the depiction of origin and proximal course and its relationship to the aortic root and the main pulmonary artery 1 and has been proposed for screening athletes and military recruits due to the lack of radiation exposure 3. It can be conducted with respiratory-gated 3D imaging (e.g. native 3D-SSFP wholeheart and/or 3D-mDixon after gadolinium contrast)."
Expected headings
"Associations"
"Coronary angiography"
"An anomalous aortic origin of the coronary artery can present with angina, palpitations, dyspnoea dizziness, syncope or might be found incidentally, on invasive coronary angiography (ICA), coronary CTA or coronary MRA. In particular, an anomalous aortic origin of the left coronary artery arising from the right coronary is more commonly associated with cardiovascular symptoms and might present with sudden cardiac death usually closely associated with exercise 1-5."
"Surgery has been felt as reasonable in the case of ventricular arrhythmias in any type of anomalous aortic origin of coronary artery 1. In older patients with anomalous aortic origin of the left coronary artery from the right coronary sinus, detailed anatomical, dynamic and functional assessment can help direct patients either to surgery or to medical management 9."
"Coronary MRA can be alternatively used for the depiction of origin and proximal course and its relationship to the aortic root and the main pulmonary artery 1 and has been proposed for screening athletes and military recruits due to the lack of radiation exposure 3. It can be conducted with respiratory-gated 3D imaging (e.g. native 3D-SSFP wholeheart and/or 3D-mDixon after gadolinium contrast)."
"other associated coronary artery anomalies (e.g. coronary hypoplasia, coronary atresia)"
"Recommendations have been given by the American Heart Association (AHA), the American College of Cardiology (ACC) and the European Society of Cardiology (ESC) in which surgery has been recommended in the setting of myocardial ischaemia attributable to an anomalous aortic origin of either left or right coronary artery (AAOCA) 1,2."