AO: Aorta PA: Pulmonary artery B: Coronary buds S: Stems of right, circumflex and left anterior descending coronary artery Sin: Sinusoids. Schematic representation of the components involved in the embryogenesis of coronary arteries. Moreover, it is important to also identify variants and anomalies without clinical relevance in their own right as complications during surgery or angioplasty can occur. The clinical symptoms may include chest pain, dyspnea, palpitations, syncope, cardiomyopathy, arrhythmia, myocardial infarction and sudden cardiac death. Based on the functional relevance of each abnormality, coronary artery anomalies can be classified as anomalies with obligatory ischemia, without ischemia or with exceptional ischemia. Although congenital coronary artery anomalies are relatively uncommon, they are the second most common cause of sudden cardiac death among young athletes and therefore warrant detailed review. We have divided this article into three groups, according to their frequency in the general population: Normal, normal variant and anomaly.
Extensive iconography supports the text, with particular attention to images obtained in vivo using non-invasive imaging. The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy.