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Review
. 2022 Feb;111(2):265-268.
doi: 10.1111/apa.16160. Epub 2021 Nov 11.

Anomalous aortic origin of coronary artery: For a challenging diagnosis, a transthoracic echocardiogram is recommended

Antimo Tessitore  1 , Thomas Caiffa  2 , Marco Bobbo  2 , Biancamaria D'Agata Mottolese  2 , Egidio Barbi  1   2 , Daniela Chicco  2
Affiliations
Review

Anomalous aortic origin of coronary artery: For a challenging diagnosis, a transthoracic echocardiogram is recommended

Antimo Tessitore et al. Acta Paediatr. 2022 Feb.

Abstract

Anomalous aortic origin of a coronary artery (AAOCA), especially the interarterial course of the right or left coronary artery, predisposes paediatric patients to myocardial ischaemia. This rare condition is a leading cause of sudden cardiac death. General paediatricians face challenges when diagnosing this anomaly, and they should pay particular attention to the recurrence of exercise-related syncope without prodromal symptoms, chest pain and dyspnoea. An accurate transthoracic echocardiogram with Doppler colour flow mapping is the best method to use to identify AAOCA. CONCLUSION: Identifying an AAOCA is challenging, and we provide advice on clinical red flags and diagnostic approaches for general paediatricians.

Keywords: anomalous origin; coronary artery; exertional syncope; sudden cardiac death; transthoracic echocardiogram.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) A standard origin of coronary arteries. (B) An anomalous origin of the right coronary artery. (C) During physical effort, the aortic root and pulmonary trunk expansion compress the anomalous artery passing through. (D) An anomalous origin of the left coronary artery. LAD, left anterior descending artery; LCA, left coronary artery; LCX, left circumflex artery; LS, left sinus; NCS, non‐coronary sinus; RCA, right coronary artery; RS, right sinus
See this image and copyright information in PMC

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