Coronary Artery Anomalies

Congenital and acquired anomalies of the coronary arteries can be generally characterized as deviations from the standard anatomy of two patent and separately arising right and left arterial blood vessels. Anomalous left coronary artery originating from the pulmonary artery (ALCAPA) is an anomalous pulmonary origin of a coronary artery. ALCAPA is a rare congenital anomaly, first described by Brooks in 1885. The first pathophysiologic explanation of coronary flow patterns in patients with ALCAPA was described by Edwards. Medical treatment has essentially no role in the management of ALCAPA. Surgery is indicated upon diagnosis. Anomalous aortic origins of the coronary arteries (AAOCA) represent one-third of all coronary artery anomalies. Although a chest radiograph and electrocardiogram remain a part of the standard work-up for all suspicion of AAOCA, they are almost always noncontributory. Single coronary artery is a rare anomaly frequently associated with complex congenital heart disease.