Abstract

Aim: Coronary artery anomalies (CAAs) occur in less than 1% of the general population and may be concomitant with other major congenital cardiac defects. Although most cases are asymptomatic, they can be associated with myocardial ischemia (MI), angina, syncope, myocardial infarction, or sudden cardiac death. CAAs are usually discovered incidentally during coronary angiography or at autopsy.
Material and Methods: We retrospectively reviewed the coronary angiography reports of 11,376 patients who underwent coronary angiography in our institution between March 2002 and December 2011 to determine the incidence of CAAs and evaluate their clinical significance.
Results: The incidence of CAAs was 1.5% (including myocardial bridging) and 1% (excluding myocardial bridging). Among the 170 patients with CAAs identified, 67.6% were male (n=115, mean age 58.4 years) and 32.4% were female (n=55, mean age 60.3 years); the overall mean age was 59.1 years. Risk factors included hypertension (45.2%, n=66), diabetes mellitus (26%, n=38), hyperlipidemia (24%, n=35), smoking (23.3%, n=34), family history of coronary artery disease (10.3%, n=15), obesity (13%, n=19), and prior myocardial infarction (20.5%, n=30). Concomitant coronary artery lesions were present in 65.3% (n=111) of patients with CAAs.
Conclusion: Coronary artery anomalies are relatively common in patients undergoing coronary angiography and may have significant clinical implications. Accurate identification and systematic classification of CAAs are essential for safe procedural planning during coronary interventions and contribute to improved clinical outcomes.

Key words: Coronary artery anomalies, coronary angiography, myocardial bridging, coronary artery disease