![]() ![]() ![]() The basic issue in the definition of a normal coronary artery (and, hence, an anomaly) is the normal spectrum of variation. RCA (RV free wall), LAD (anteroseptal), OM (LV free wall) Right and left anterior sinuses (upper midsection) LAD indicates left anterior descending artery Cx, circumflex artery RCA, right coronary artery RV, right ventricular OM, obtuse marginal artery and LV, left ventricular. Normal Features of the Coronary Anatomy in Humans Feature Only multicenter collaboration on protocols dedicated to CAAs can give rise to the large-scale studies needed to define the prognosis and optimal treatment of these disorders. To be competent to advise CAA carriers, especially in the context of sporting or military activities, cardiologists should undergo specific training in these disorders. ![]() Patients symptomatic of anomalous origination of a coronary artery from the opposite sinus may undergo medical treatment/observation, coronary angioplasty with stent deployment, or surgical repair. Intravascular ultrasonography is the preferred means to evaluate the mechanisms responsible for ischemia in anomalous origination of a coronary artery from the opposite sinus and other potentially significant CAAs. For this subgroup, solid diagnostic screening protocols should be established, especially for athletes and other young individuals subjected to extreme exertion. The present review focuses on anomalous origination of a coronary artery from the opposite sinus-the subgroup of CAAs that has the most potential for clinical repercussions, specifically sudden death in the young. To understand the clinical impact of CAAs, the fundamental challenge is the firm establishment, for a particular type of CAA, of a mechanism capable of interference with the coronary artery’s function, which is to provide adequate blood flow to the dependent myocardium. The subject of CAAs is undergoing profound evolutionary changes related to the definition, morphogenesis, clinical presentation, diagnostic workup, prognosis, and treatment of these anomalies.
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