Prevalence and characteristics of coronary artery anomalies in an adult population undergoing multislice computed tomography

Introduction: The real prevalence of coronary artery anomalies (CAA) varies according to the diagnostic method used, the classification criteria used and the population studied. Cardiac imaging by multislice computed tomography (MSCT) is a very reliable method for detecting CAA. The purpose of this study is to determine, through MSCT, the prevalence of CAA in adult individuals in our environment. Methods and results: Based on the modified Angelini classification, the MSCTs of 1000 consecutive patients were evaluated. There were 202 coronary anomalies identified in 191 individuals, with a prevalence of 19%. Seventy-eight percent of patients were men and the average age was 58 years. The types of CAA observed were: 1) myocardial bridge 132 patients (69%), 2) wrong sinus coronary artery 26 patients (14%), 3) abnormal location of the coronary ostium, within or near the proper sinus 12 (6%), 4) single coronary artery 8 (4%), 5) ectasia or aneurysm 7 (3%), 6) absent left main coronary artery or split left coronary artery 3 (2%), and 7) coronary artery fistulae 3 (2%). Disregarding the myocardial bridges, 59 (31%) CAAs were found, which is equivalent to 5.9% of the general population. In addition, 9 (5%) patients had high-risk anatomy. The most commonly found wrong sinus coronary artery was the circumflex artery originating from the right sinus. Conclusions: Through MSCT, the most commonly found coronary anomaly is the myocardial bridge, followed by the wrong sinus coronary artery. The results of this study corroborate that MSCT is an excellent non-invasive modality in the evaluation of patients with suspected coronary artery anomalies. (authors)