Purpose or Case Report: Coronary artery anomalies span a broad spectrum of clinical outcomes from clinically insignificant to deadly. Although uncommon, these conditions can be devastating and reflect a significant proportion of premature deaths in young people, particularly young athletes. As imaging becomes more common in the pediatric and young adult population, as well as the increase of cardiac imaging in adults, many of these anomalies can be found incidentally. The purpose of this educational exhibit is to provide a framework for assessing coronary artery anomalies and to review several classic cases. The exhibit will discuss anomalies of origin, course, and termination, as well as hemodynamically significant and non-hemodynamically significant anomalies. Specific cases include interarterial course, prepulmonic course, retro aortic course, ALCAPA, ARCAPA, coronary artery fistula, and coronary artery aneurysms (Kawasaki, MIS-C). Examples of post-procedural findings will also be included. Given the variety of coronary artery anomalies and varied clinical presentations, it is important for radiologists to recognize and correctly diagnose these diseases to ensure appropriate management.
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