Coronary artery anomalies: what we know and what we have to learn. A proposal for a new clinical classification

Area of Science:

• Cardiology
• Medical Diagnostics

Background:

• Anatomic and pathophysiological details of coronary artery anomalies (CAAs) are well-established.
• Limited data exists on the clinical relevance and management protocols for various CAAs.
• CAAs are frequently discovered incidentally during cardiac diagnostics, posing challenges for clinical management.

Purpose of the Study:

• To address the lack of clinical relevance data for CAAs.
• To propose a practical clinical classification system for CAAs.
• To guide management and follow-up protocols for patients with CAAs.

Main Methods:

• Review of existing literature on coronary artery anomalies.
• Development of a novel clinical classification system based on clinical significance.
• Categorization of CAAs into four classes: benign, relevant, severe, and critical.

Main Results:

• The proposed classification categorizes CAAs into four distinct classes based on clinical significance.
• Class I: Benign CAAs.
• Class II: Relevant CAAs associated with myocardial ischemia.
• Class III: Severe CAAs linked to sudden cardiac death.
• Class IV: Critical CAAs combining features of Classes II and III with coronary artery disease.

Conclusions:

• A practical clinical classification for CAAs is proposed, focusing on clinical significance.
• This classification aims to standardize the management and follow-up of patients with CAAs.
• The system provides a framework for clinicians encountering CAAs as incidental findings.