To illustrate the utility of computed tomography coronary angiography (CTCA) in diagnosis and evaluation of a range of coronary artery anomalies.

Coronary artery anomalies refer to a comprehensive group of conditions that describe congenital variations in the anatomical distribution of the coronary arteries beyond that of the accepted norm. Their prevalence is up to 1.3% in adults[1], yet in many cases impose an increased risk of mortality, and thus are critical to recognise and diagnose accurately. ECG-gated iodinated contrast computed tomography coronary angiography has an important imaging role in coronary artery disease in symptomatic patients but is also employed increasingly for suspected coronary artery anomalies. The...

Coronary artery anomalies encompass a diverse range of pathological and non-pathological deviances from the normal arrangement. Variations are commonly seen in the coronary ostia, ramifications of the coronary arteries and courses of the coronary arteries (Figure 1). [Fig 1] Anomalies in Origin Absent left main (LM) or separate origin of left anterior descending (LAD) and left circumflex (LCx) from the left sinus of Valsalva has been found to be the most common anomaly of coronary artery origin, followed by anomalous origin of the LCx from...

Coronary artery anomalies are relatively rare but of critical importance in recognition, especially prior to angiographic and surgical planning, with many associated with sudden cardiac death. While CTCA has been increasingly used for coronary atheromatous disease assessment, it is crucial for the reporting radiologists to have awareness of a wide range of coronary anomalies and accurately describe them in CT reports to enable proper management. CTCA has become the modality of choice to assist with diagnosis and further evaluation of coronary anomalies.

Yildiz, A., et al., Prevalence of Coronary Artery Anomalies in 12,457 Adult Patients Who Underwent Coronary Angiography. Clinical Cardiology, 2010. 33(12): p. E60-E64. Ghadri, J.R., et al., Congenital coronary anomalies detected by coronary computed tomography compared to invasive coronary angiography. BMC cardiovascular disorders, 2014. 14: p. 81-81. Yamanaka, O. and R.E. Hobbs, Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Catheterization and Cardiovascular Diagnosis, 1990. 21(1): p. 28-40. Angelini, P., Coronary Artery Anomalies. Circulation, 2007. 115(10): p. 1296-1305. Ho, J.S. and N.E. Strickman, Anomalous...