Anomalous Left Coronary Artery from the Rigth Coronary Artery Flashcards
(27 cards)
What is anomalous aortic origin of a coronary artery (AAOCA)?
AAOCA is a congenital abnormality of the origin or course of a coronary artery that arises from the aorta.
AAOCA involves an abnormal origin of one of the coronary arteries from the wrong sinus of Valsalva.
How is normal coronary artery anatomy characterized?
Normal coronary artery anatomy is characterized by two ostia centrally placed in the right and left sinus of Valsalva.
The main left coronary artery (LCA) and the right coronary artery (RCA) originate from these ostia.
What are the branches of the left coronary artery (LCA)?
The LCA branches into the left anterior descending artery and circumflex artery.
The circumflex artery courses around the left atrioventricular groove.
What does the right coronary artery (RCA) provide?
The RCA provides an infundibular branch to the anterior side of the heart.
After providing this branch, the RCA courses backward in the atrioventricular groove.
What percentage of sudden cardiac death in young athletes in the United States is attributed to AAOCA?
AAOCA accounts for 17% of sudden cardiac death in young athletes.
This makes it the second leading cause of such deaths.
What is the reported prevalence of anomalous right coronary artery (ARCA)?
The prevalence of ARCA is reported to be 0.06-0.9%.
This varies depending on the diagnostic method applied.
What is the reported prevalence of anomalous left coronary artery (ALCA)?
The prevalence of ALCA is reported to be 0.025-0.15%.
This statistic also depends on the diagnostic method used.
What is the reported prevalence of anomalous circumflex coronary artery?
The prevalence of anomalous circumflex coronary artery is reported to be 0.02-0.67%.
This indicates variability based on the diagnostic criteria.
What are the types of anomalous coronary arteries based on origin from the aorta?
- Anomalous left coronary artery
- Anomalous right coronary artery
- Anomalous circumflex coronary artery
- Anomalous left anterior descending coronary artery
- Single coronary artery
These classifications help in identifying specific anomalies for diagnosis and treatment.
How are anomalous coronary arteries further subdivided based on their course?
- Inter-arterial
- Intra-mural
- Intra-myocardial
- Retro-aortic
- Pre-pulmonic
Understanding the course of the artery is crucial for surgical planning and risk assessment.
What is the definition of an inter-arterial anomalous coronary artery?
The coronary artery travels between the aorta and the pulmonary artery
This positioning can lead to potential complications, especially during physical exertion.
Define intra-mural anomalous coronary artery.
The coronary artery travels within the aortic wall
This anomaly can be difficult to diagnose and may require advanced imaging techniques.
What characterizes an intra-myocardial anomalous coronary artery?
The coronary artery travels into the myocardium instead of a normal epicardial course
This can increase the risk of ischemia and myocardial infarction.
What does a retro-aortic coronary artery indicate?
The coronary artery travels behind the aorta
This configuration may affect blood flow dynamics and surgical access.
What is meant by a pre-pulmonic coronary artery?
The coronary artery travels anterior to the pulmonary artery
This positioning can be associated with certain congenital heart defects.
What are the classifications of ostial morphology of anomalous coronary arteries?
- Round
- Oval
- Slit like
Ostial morphology can influence the likelihood of obstruction and ischemic events.
Define round ostial morphology.
Antero-posterior diameter equals transverse diameter
This shape may provide a more favorable blood flow compared to other morphologies.
What is the definition of oval ostial morphology?
Antero-posterior diameter is 50-90% of transverse diameter
This configuration may present a moderate risk of obstruction.
Fill in the blank: Slit like ostial morphology has an antero-posterior diameter of _______.
<50 % of transverse diameter
This morphology is often associated with a higher risk of significant obstruction.
What imaging modalities are useful for defining features of anomalous coronary artery?
CT and MRI
These modalities are used when a diagnosis of anomalous coronary artery is suspected.
What is the most common presentation of patients with AAOCA?
Asymptomatic
Sudden death can be the first manifestation in some patients.
What is the primary mechanism proposed for ischemia in AAOCA?
Compression of anomalous coronary artery during exercise
This can lead to myocardial ischemia and ventricular fibrillation/tachycardia.
Fill in the blank: Compression of _______ segment by aortic expansion occurs during exercise.
intra-mural
What are some proposed mechanisms for coronary compressions in AAOCA? List three.
- Compression of intra-mural segment by aortic expansion during exercise
- Torsion, compression or kinking of inter-arterial coronary artery during exercise
- Slit like ostia and flap like closure of the coronary artery during exercise
