Anomalous Origin of the Coronary Arteries

Introduction to Anomalous Origin of the Coronary Arteries

Anomalous origin of the coronary arteries (AOCA) is a congenital heart defect characterized by the abnormal origin or course of one or more coronary arteries. This condition affects approximately 1% of the general population and can range from benign variants to potentially life-threatening anomalies.

The coronary arteries typically arise from the aortic sinuses, with the left main coronary artery originating from the left coronary sinus and the right coronary artery from the right coronary sinus. In AOCA, these arteries may originate from unexpected locations or take abnormal paths, which can lead to compromised blood flow to the myocardium.

Understanding AOCA is crucial for healthcare professionals, as it can be associated with sudden cardiac death, especially in young athletes. Early detection and appropriate management are essential to prevent adverse outcomes and improve patient prognosis.



Objective QnA: Objective QnA: Anomalous Origin of the Coronary Arteries
  1. What is the definition of anomalous origin of the coronary arteries?
    Coronary arteries that originate from an abnormal location on the aorta or pulmonary artery
  2. What is the most common type of coronary artery anomaly?
    Separate origin of the left anterior descending and left circumflex arteries
  3. Which anomalous coronary artery origin is associated with the highest risk of sudden cardiac death?
    Left coronary artery arising from the right sinus of Valsalva
  4. What is the estimated prevalence of coronary artery anomalies in the general population?
    Approximately 1%
  5. Which imaging modality is considered the gold standard for diagnosing coronary artery anomalies?
    Coronary CT angiography
  6. What is the term for a coronary artery that originates from the pulmonary artery instead of the aorta?
    Anomalous origin of the coronary artery from the pulmonary artery (ALCAPA)
  7. Which coronary artery is most commonly affected in ALCAPA?
    Left coronary artery
  8. What is the alternative name for ALCAPA syndrome?
    Bland-White-Garland syndrome
  9. At what age do symptoms typically appear in infants with ALCAPA?
    2-3 months of age
  10. What is the most common presenting symptom of ALCAPA in infants?
    Congestive heart failure
  11. Which ECG finding is characteristic of ALCAPA?
    Q waves in leads I and aVL
  12. What is the primary goal of surgical treatment for ALCAPA?
    To establish a two-coronary system
  13. Which surgical technique is commonly used to repair ALCAPA?
    Coronary artery reimplantation
  14. What is the term for a single coronary artery arising from the aorta?
    Single coronary artery
  15. Which congenital heart defect is most commonly associated with coronary artery anomalies?
    Tetralogy of Fallot
  16. What is the mechanism of myocardial ischemia in anomalous aortic origin of a coronary artery?
    Compression of the anomalous artery between the aorta and pulmonary artery
  17. Which age group is at highest risk for sudden cardiac death due to anomalous coronary arteries?
    Adolescents and young adults
  18. What is the term for an anomalous coronary artery that courses between the aorta and pulmonary artery?
    Interarterial course
  19. Which non-invasive imaging modality can be used to assess coronary artery flow in anomalous coronaries?
    Stress perfusion cardiac MRI
  20. What is the recommended treatment for asymptomatic patients with right coronary artery arising from the left sinus?
    Observation and exercise restrictions
  21. Which anomalous coronary pattern is associated with "steal phenomenon"?
    ALCAPA (Anomalous left coronary artery from the pulmonary artery)
  22. What is the long-term survival rate after surgical repair of ALCAPA?
    Approximately 90% at 20 years
  23. Which diagnostic test is used to assess the functional significance of anomalous coronary arteries in older children?
    Exercise stress test
  24. What is the term for an anomalous coronary artery that courses within the wall of the aorta?
    Intramural course
  25. Which coronary anomaly is most commonly associated with sudden cardiac death in young athletes?
    Left main coronary artery arising from the right sinus of Valsalva
  26. What is the recommended follow-up interval for patients with repaired coronary artery anomalies?
    Annual cardiac evaluation
  27. Which imaging finding suggests a high-risk anomalous coronary artery?
    Slit-like orifice of the anomalous coronary
  28. What is the primary indication for surgical intervention in asymptomatic patients with anomalous coronary arteries?
    High-risk anatomy (e.g., interarterial course with slit-like orifice)
  29. Which surgical technique involves creating a new ostium for the anomalous coronary artery?
    Unroofing procedure
  30. What is the recommended management for patients with incidentally discovered anomalous coronary arteries?
    Comprehensive evaluation including imaging and functional testing




Disclaimer

The notes provided on Pediatime are generated from online resources and AI sources and have been carefully checked for accuracy. However, these notes are not intended to replace standard textbooks. They are designed to serve as a quick review and revision tool for medical students and professionals, and to aid in theory exam preparation. For comprehensive learning, please refer to recommended textbooks and guidelines.





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