Congenital anomalies of the coronary circulation.

Congenital anomalies of the coronary circulation have been associated with significant cardiac consequences, ranging from angina pectoris to sudden death in otherwise healthy individuals, yet neither systematic evidence nor published guidelines exist to guide cardiologists in the care of such patients. Three cases of coronary anomalies that were detected incidentally in the course of routine cardiac catheterization are presented. Although none of the patients presented suffered complications as a direct result of their coronary anomaly, little is known about the long term effects. A significant number of coronary anomalies are discovered incidentally; however, many remain undetected until they lead to a serious cardiac event. Therefore, more studies are needed to determine which congenital coronary anomalies carry serious cardiac risks, and which are relatively benign. This could lead to the development of guidelines for practitioners in the management of such patients.