Learning objectives
- Recognise and distinguish between normal coronary artery anatomy, anatomical variations and congenital anomalies
- Develop a standardised and comprehensive approach to the assessment and classification of coronary artery anomalies
Background
The coronary arteries – named from the Latin ‘corona’ meaning crown – encircle the heart ensuring the myocardium remains supplied with an uninterrupted flow of blood. The nature by which these arteries encase and supply the heart is subject to significant variability. In this pictorial review we will cover the anatomy, variations and anomalies that can occur and their consequences.
Findings and procedure details
NORMAL ANATOMY:
There are four main coronary arteries: the right coronary artery (RCA), Left main coronary artery (LM), left anterior descending artery (LAD) and left circumflex artery (LCX).[1] Coronary arteries are the first aortic branches arising from aortic root at the level of Sinuses of Valsalva.[2][Fig 1]
Right Coronary Artery: Arising from the right coronary sinus it runs inferiorly into the right atrioventricular groove toward the posterior interventricular septum.[1,3,4] This gives off the conus branch supplying the right ventricle outflow tract; the sinoatrial node branch...
Conclusion
Coronary artery variations and anomalies are commonly encountered in cardiac imaging and encompass a wide variety of aberrant anatomy. They range from asymptomatic forms that are only recognized incidentally to those causing haemodynamically compromise. Coronary CT has emerged as the diagnostic standard for evaluating coronary arteries and their anomalies. It is important to be familiar with imaging features of coronary anomalies and their clinical significance to make a correct clinical diagnosis and guide treatment planning.
Personal information and conflict of interest
M. Kotnik:
Nothing to disclose
J. Y. Sun:
Nothing to disclose
J. Weir-McCall:
Nothing to disclose
Nothing to disclose
References
Pannu HK, Flohr TG, Corl FM, Fishman EK (2003) Current Concepts in Multi-Detector Row CT Evaluation of the Coronary Arteries: Principles, Techniques, and Anatomy. Radiographics 23:111–125. https://doi.org/10.1148/rg.23si035514
Loukas M, Groat C, Khangura R, et al (2009) The normal and abnormal anatomy of the coronary arteries. Clin Anat 22:114–128. https://doi.org/10.1002/ca.20761
Neves PO, Andrade J, Monção H (2015) Coronary anomalies: what the radiologist should know. Radiol Bras 48:233–241. https://doi.org/10.1590/0100-3984.2014.0004
EPOSTM - C-1905. https://epos.myesr.org/poster/esr/ecr2016/C-1905. Accessed 18 Jan 2021
Diagnostic Imaging: Cardiovascular - Suhny Abbara, Thomas Gregory Walker, Steven...