Question:

Which of the following is false about the coronary artery anomalies?
1. It is seen in less than 1% of the unselected population.
2. Anomalies of the Right coronary artery are more common.
3. Anomalous origin and course are more common than fistulous termination.
4. May be associated with congenital heart diseases.
5. Always asymptomatic.





Answer:

The correct answers for the question "Which of the following is false about the coronary artery anomalies?" are:

2. Anomalies of the Right coronary artery are more common.

5. Always asymptomatic.



Explanation
1. It is seen in less than 1% of the unselected population. [Coronary artery anomalies are an unusual morphologic feature seen in less than 1% of unselected population. If the incidence is more than 1%, then it is referred to as normal variant. Anomalies of the coronary arteries may be found incidentally in 0.3%-1.0% of healthy individuals depending on whether the evaluation is on autopsy, catheter angiography, surgery or CT angiography.]

2. Anomalies of the Left circumflex artery are more common. [The anomalies of the Left circumflex are more common and account for nearly two- thirds of the reported single coronary artery anomalies, especially the Left circumflex arising separately from the right coronary sinus followed by Left circumflex arising from the proximal Right coronary artery.]

3. Anomalous origin and course are more common than fistulous termination.

4. May be associated with congenital heart diseases [Higher incidence of coronary arteries anomalies is associated with an abnormal aortic valve, the persistent truncus arteriosus and pulmonary atresia.]

5. May be symptomatic [Such anomalies may remain clinically silent or may manifest as exertional chest pain, syncope, myocardial ischemia and infarction, malignant ventricular arrhthymias  and even sudden cardiac death in affected individuals, especially young atheletes or exercising individuals.]



From the manuscript:
Anomalous Single Coronary Artery on Low Dose MDCT
Radiology Case. 2013 May; 7(5):6-15


This article belongs to the Cardiac section.




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From the manuscript

Anomalous Single Coronary Artery on Low Dose MDCT

Free full text article: Anomalous Single Coronary Artery on Low Dose MDCT

Abstract
Coronary artery anomalies may involve the origin, course, and structure of epicardial coronary arteries and occur in less than 1% of the general population. Clinical presentation ranges from being completely asymptomatic to sudden death. Multi-detector computed tomography has come a long way in the diagnosis of coronary artery anomalies since the introduction of 4 rows of detectors in scanners, considering its non invasive nature and the benefits of 3D reconstruction. Defining the coronary anatomy helps in clinical decision making and timely intervention. Since repeated angiographies may be required, low dose CT is an excellent investigation for diagnosis and post interventional follow up rather than repeated invasive catheter angiographies or high dose CT examination. We report two cases of clinically significant single coronary artery anomalies; a case of single Right coronary artery and another case of single Left coronary artery (Anomaly of origin & course).






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