Coronary artery anomalies overview: The normal and the abnormal

Area of Science:

• Cardiovascular Science
• Embryology
• Anatomical Pathology

Background:

• Congenital coronary artery anomalies are uncommon but a leading cause of sudden cardiac death in young athletes.
• Understanding normal coronary anatomy and its variants is crucial for clinical practice.

Purpose of the Study:

• To provide a comprehensive overview of coronary embryology and normal coronary anatomy.
• To describe common normal variants and typical patterns of anomalous coronary artery anatomy.
• To classify anomalies based on functional relevance and potential for ischemia.

Main Methods:

• Review of existing literature and iconography.
• Focus on in vivo non-invasive imaging techniques.
• Classification of coronary artery patterns into normal, normal variant, and anomaly groups.

Main Results:

• Detailed description of normal coronary anatomy and embryology.
• Categorization of coronary artery anomalies based on frequency and clinical relevance.
• Identification of anomalies with obligatory, absent, or exceptional ischemia.

Conclusions:

• Congenital coronary artery anomalies, though rare, are critical due to their association with sudden cardiac death.
• Accurate identification of variants and anomalies is essential to prevent surgical or interventional complications.