Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2016; 8(6): 537-555
Published online Jun 28, 2016. doi: 10.4329/wjr.v8.i6.537
Coronary artery anomalies overview: The normal and the abnormal
Adriana DM Villa, Eva Sammut, Arjun Nair, Ronak Rajani, Rodolfo Bonamini, Amedeo Chiribiri
Adriana DM Villa, Eva Sammut, Amedeo Chiribiri, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London SE1 7EH, United Kingdom
Arjun Nair, Department of Radiology, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London SE1 7EH, United Kingdom
Ronak Rajani, Department of Cardiology, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London SE1 7EH, United Kingdom
Rodolfo Bonamini, Division of Cardiology, Department of Medical Sciences, University of Turin, 10124 Turin, Italy
Author contributions: All authors collaborated to the manuscript and read and approved the final version.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amedeo Chiribiri, MD, PhD, FHEA, Wellcome Trust/EPSRC Medical Engineering Centre, Division of Imaging Sciences, Guy’s and St Thomas’ Hospital NHS Foundation Trust, 4th Floor Lambeth Wing, London SE1 7EH, United Kingdom. amedeo.chiribiri@kcl.ac.uk
Telephone: +44-020-71888259 Fax: +44-020-71885442
Received: November 27, 2015
Peer-review started: November 30, 2015
First decision: December 28, 2015
Revised: January 21, 2016
Accepted: March 14, 2016
Article in press: March 16, 2016
Published online: June 28, 2016
Abstract

The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy. Extensive iconography supports the text, with particular attention to images obtained in vivo using non-invasive imaging. We have divided this article into three groups, according to their frequency in the general population: Normal, normal variant and anomaly. Although congenital coronary artery anomalies are relatively uncommon, they are the second most common cause of sudden cardiac death among young athletes and therefore warrant detailed review. Based on the functional relevance of each abnormality, coronary artery anomalies can be classified as anomalies with obligatory ischemia, without ischemia or with exceptional ischemia. The clinical symptoms may include chest pain, dyspnea, palpitations, syncope, cardiomyopathy, arrhythmia, myocardial infarction and sudden cardiac death. Moreover, it is important to also identify variants and anomalies without clinical relevance in their own right as complications during surgery or angioplasty can occur.

Keywords: Coronary arteries, Anomalies, Variants, Anatomy, Heart

Core tip: Congenital coronary artery anomalies are not common, but it is crucial to identify them as in some cases they can cause severe reduction of blood flow to the myocardium (ischaemia) and lead to chest pain, arrhythmias and sudden cardiac death, and that in themselves can increase the risk of routine procedures. The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy with the aid of non-invasive medical images.