الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Aim of work: This study is conducted to review the recent literatures and researches concerning coronary artery anomalies, clinical implication of these anomalies, the advance in diagnosis particularly imaging techniques and advance in their management. Coronary artery anomalies are some of the most confusing, neglected topics in cardiology. Although the medical community and general public are increasingly aware that coronary anomalies can be fatal (typically in young, previously “healthy” athletes), the reasons for the sudden fatal event and the frequency with which it occurs are generally unclear. Hemodynamically significant anomalies of the coronary arteries are characterized by abnormalities of myocardial perfusion, which lead to an increased risk of myocardial ischemia or sudden death. These anomalies include an anomalous origin of either the LCA or the RCA from the pulmonary artery, an anomalous course between the pulmonary artery and the aorta (interarterial) of either the RCA arising from the left sinus of Valsalva or the LCA arising from the right sinus of Valsalva, occasional myocardial bridging, and congenital coronary artery fistula. The association of coronary artery anomalies and sudden cardiac death appears to be exclusively found in patients with an interarterial vessel, in whom the anomalous vessel passes between the aortic root and right ventricular outflow tract (RVOT) or pulmonary artery. Clinical diagnosis of coronary artery anomalies is difficult. The initial diagnostic examination is typically conventional coronary angiography However, even with multiple projections and the use of pulmonary artery catheters, the identification of the proximal course of the vessel can be difficult within the angiographic suite.. Multislice CT, with its short acquisition time, can provide detailed anatomy of coronary arteries non-invasively. MR angiography provides an accurate assessment of the course of anomalous coronary arteries and can be used as an adjunctive technique when results of coronary angiography are equivocal. Finally, when anomalous coronary artery is suspected, every effort should be directed towards early diagnosis and early management.