Anomalous Origin of Coronary Arteries: A Diagnostic Dilemma

With the increasing use of imaging for screening and diagnostic purposes, particularly coronary CT angiography, the number of adult patients diagnosed with anomalous origin of the coronary arteries (AOCA) has risen significantly. While current guidelines offer a general framework for managing and treating AOCA, patients present with diverse anomalies, symptoms, and clinical presentations, making broad recommendations less universally applicable. Notably, a wide range of treatment options exists, but there is no clear consensus on the best intervention strategy. Presented here are three cases of AOCA emphasizing the anatomical variations, clinical presentations, and the utility of coronary CT angiography in delineating anatomy and identifying high-risk features.