Two-dimensional and Doppler transesophageal echocardiographic delineation and flow characterization of anomalous coronary arteries in adults

Angiotomografia coronariana multislice na avaliação da origem anômala das artérias coronarianas

“…Another branch of the RCA found in 59% of the individuals is the sinoatrial nodal artery, running posteriorly along the upper portion of the atrial septum and anterior wall of the right atrium, supplying the sinus node and right atrium. In 38% of individuals, this artery originates from the left coronary artery, and in 3% it originates from both arteries 7 .…”

“…Its first branch is the conal (or infundibular) artery, which runs anteriorly, supplying the right ventricular outflow tract or infundibular region. In 50% of the population, the infundibular branch arises separately from the right coronary sinus 7 .…”

“…The origin and proximal trajectory of anomalous coronary arteries are the major predictors of severity 14 . Currently, it constitutes the second most common cause of sudden cardiovascular death in competitive athletes 15 and can also be the cause of heart failure and death in infants 16,17 .…”

“…The evolution of AOCA is highly variable and may be benign or have potentially severe outcomes, such as myocardial infarction and sudden death. Among the available diagnostic methods, multislice CT angiography of the coronary arteries has great potential in the anatomical evaluation of these arteries 7 ( Figs. 1 and 2).…”

ALADPA : Snake in the Heart

“…diastolic flow in the pulmonary artery, regional wall motion abnormality of LAD territory, mitral regurgitation, increased echogenicity of the papillary muscle and adjacent endocardium due to fibrosis and fibroelastosis are additional clues to the echo diagnosis of ALADPA. 7 If the results of noninvasive imaging points towards suspected ALADPA, then coronary angiography, Cardiac MRI and cardiac CT-scans can definitely help in anatomical delineation of the anomaly. 8,9 Treatment includes medical stabilization followed by definitive repair of the abnormal anatomy.…”