interarterieller Verlauf der RCA

Congenital

coronary anomalies detected by coronary computed tomography compared to invasive coronary angiography. A patient with an anomalous origination of the right coronary artery (RCA). (a) Volume-rendered three-dimensional image showing that RCA is arising from the left coronary sinus with anomalous course between aorta and pulmonary trunk. (b) Axial images of the same patient showing the potentially malignant course of the RCA.

bmccardiovascdisord.biomedcentral.com • CC-by-2.0

Missed

myocardial infarction in a vicenarian with malignant anomalous right coronary artery causing acute coronary syndrome: a case report. Multi-modality imaging of anomalous right coronary artery

jmedicalcasereports.biomedcentral.com • CC-by-4.0

Prevalence

and characteristics of coronary artery anomalies in an adult population undergoing multidetector-row computed tomography for the evaluation of coronary artery disease. Three-dimensional volume-rendered image shows the RCA arising from the left coronary sinus and with a malignant inter-arterial course between the pulmonary artery (PA) and the aorta (Ao)

bmccardiovascdisord.biomedcentral.com • CC-by-4.0

Hier werden Begriffe / Krankheitsbilder genannt, die ähnlich sind oder klingen, aber nicht das Gleiche sind.

nicht verwechseln mit: intraatrialer Verlauf der RCA

Lizenz: CC BY-SA 4.0

interarterieller Verlauf der RCA

atypischer Verlauf der Koronararterien Radiopaedia • CC-by-nc-sa 3.0 • de

Anomalous course of a coronary artery is a type of congenital coronary artery anomaly. It may represent a benign and incidental finding, but rarely it is a malignant course predisposing patients to life-threatening myocardial ischemia or arrhythmias, depending on where the artery runs.

Clinical presentation

The majority (approximately 80%) of anomalous coronary artery courses are benign and asymptomatic. However, on rare occasions, it may result in ischemia, arrhythmias, or sudden death. Most symptomatic patients present at a young age.

Pathology

The coronary artery may pass between the aorta and the main pulmonary artery, representing a so-called interarterial course. It may be associated with a "slit-like" orifice in which an acute angle course at the ostium is more prone to occlusion. During physical activity, the artery may be compressed, and the flow within it may be compromised. The presence of a "slit-like" orifice or intramural course of the coronary artery within the aortic wall is more predictive of adverse outcome than the interarterial course alone.

There are four common courses for an anomalous coronary artery arising from the opposite sinus :

malignant course
- interarterial right or left (i.e. between the aorta and the pulmonary artery): this is the most dangerous as it carries a high risk of sudden cardiac death
benign course
- retroaortic coronary course
- prepulmonic coronary course
- septal (subpulmonic)

Treatment and prognosis

The treatment of anomalous coronary arteries is controversial. Mainly patients with a benign course rarely need surgical treatment. Symptomatic patients with an interarterial course may require surgical "re-implantation" of the anomalous coronary artery or "de-roofing" if an intramural course is present.