Arq Bras Cardiol: Imagem cardiovasc 2024; 37(4): e20240075
Rare Presentation of an Anatomical Congenital Anomaly of the Coronary Arteries on Computed Tomography Angiography
DOI: 10.36660/abcimg.20240075i
Introduction
Anomalous origin of the coronary arteries represents a heterogeneous group of alterations in the origin and course of these vessels, ranging from the most common, asymptomatic and low risk, to the rarest and highest risk, which may eventually be symptomatic or have sudden death as their first manifestation., Their prevalence corresponds to 1.3% of patients undergoing coronary angiography, but this number may be higher depending on the diagnostic method and the population selected, representing the second leading cause of sudden death in young athletes, behind only hypertrophic cardiomyopathy.,
Within this group, coronary anomalies with a single ostium are present in a smaller proportion of the population, approximately 0.004% to 0.098%. They are most often asymptomatic, but they may manifest with chest pain, dyspnea, palpitation, myocardial infarction, and sudden death., The presentation of this anomaly has worse prognosis in the presence of an interarterial vessel course (between the aorta and pulmonary trunk), an acute angle of origin, and atherosclerotic plaque; the latter change has a higher incidence in anomalous vessels on account of the greater stress on the arterial wall., In addition to presenting in isolation, they may also be associated with other alterations such as cardiac fistulas or a bicuspid aortic valve.
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