Imaging Approaches for Coronary Artery Anomalies: Purpose and Techniques
Purpose of Review
Comprehensive discussion of alternative techniques in imaging coronary artery anomalies (CAAs) in different diagnostic scenarios.
At primary screening, intramural course essentially correlates with stenosis and clinical repercussion in some types of CAAs. Potential clinical aims in imaging patients with CAAs may be primary screening, severity evaluation, preoperative planning, and postoperative follow-up. Appropriate techniques are echocardiography, magnetic resonance imaging, computed tomography angiography, and intravascular ultrasound (IVUS). Rarely, IVUS may be needed in patients with potentially serious CAAs and has unique advantages and limitations. IVUS data are essential for in-depth knowledge of mechanisms of coronary dysfunction (exercise-related dynamic stenosis of variable severity) and for indicating interventional treatment.
In adolescents or adults, intramural course of an anomalous coronary artery is the only important feature accompanied by stenosis of potential severity and is especially relevant in patients with a high-risk status (elite sport athletes, military recruits).
KeywordsAthlete screening Coronary artery anomalies Sudden death in athletes Coronary artery stenosis Intravascular ultrasound
Dr. Carlo Uribe has provided expert assistance with the imaging used in this manuscript.
Compliance with Ethical Standards
Conflict of Interest
Paolo Angelini declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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