Adult congenital anomalies of the coronary arteries described over 31 years of angiographic studies in the Principado de Asturias: Angiographic and clinical characteristics

Objective. The aim of this study was to determine the incidence or adult co ngenital anomalies of the coronary arteries over 31 years of angiographic s tudies, describing their angiographic and clinical characteristics. The res ults have been compared with the main series published. Methods. The diagnostic angiographic reports done in the Principado de Astu rias from 1968 to 1999 are reviewed. In those in which a congenital anomaly was diagnosed, the clinical report and the angiography were studied. The i nitial course of the anomaly was defined following angiographic criteria. Results. Thirteen thousand five hundred reports were reviewed describing 75 patients with 75 anomalies (0.5%) including: anomalous origin of the left circumflex coronary artery (n = 24), coronary artery fistulae (n = 21), bot h coronary arteries arising from the left coronary sinus (n = 15), single c oronary arteries (n = 6), both coronary arteries arising from the right cor onary sinus (n = 2), separated origin of anterior descending and left circu mflex coronary arteries (n = 3), anterior descending artery arising from th e right coronary sinus (n = 2), and others (n = 1). Angiographic studies we re done because of: angina (59%), dysnea (25%), atypical chest pain (7%), s yncope (3%), dizziness (3%) and palpitations (3%). The initial course was r etroaortic in ail the circumflex arteries, interarterial in the right coron aries, anterior in the anterior descending arteries and retroaortic, septal and combined, in the left coronaries. Conclusions. Adult congenital anomalies of the coronary arteries are not ve ry common and are usually casual findings of diagnostic angiographic studie s. Left circumflex coronary artery anomalies are the most frequently diagno sed.