An anomalous coronary artery (ACA) is the medical term for a developmental abnormality of a coronary artery. These are arteries that supply blood to the heart.

There are many types of ACA. The artery may be abnormally narrow, join the heart in an unusual position, or branch in an unusual way. Some abnormalities do not cause any symptoms, while others can cause serious complications and lead to sudden cardiac death.

This article describes what an ACA is and how it can affect the body. We also outline the causes and symptoms of an ACA and provide information on how doctors diagnose and treat the condition. Finally, we offer advice on when to contact a doctor.

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An ACA is the medical term for an abnormality of a coronary artery. Medical professionals recognize that defining “normal” can be difficult. However, experts estimate that ACA affects between 0.21 to 5.79% of the population. According to a 2019 review, the average prevalence is around 1%.

Examples of ACA abnormalities include:

  • Narrowing: The artery may be narrower than is typical or have an unusual shape or size.
  • Misplacement: The artery may run its course in an unusual position.
  • Branching: The artery may not follow the typical branching pattern.
  • Fistulas: This is where the artery connects to another part of the heart, such as a cardiac chamber.

An ACA can impact the body in many ways, depending on the type of abnormality.

For example, narrowing of a coronary artery can affect the flow of oxygen-rich blood away from the heart. This could then affect the oxygen supply to the rest of the body.

It also means that the part of the heart that pumps the oxygen-rich blood to the rest of the body has to work harder to ensure the body gets enough oxygen. This extra exertion can cause the heart to thicken.

An ACA is typically a congenital abnormality, meaning that a person is born with the issue. Experts do not know why some people have heart abnormalities. However, it may relate to something impacting the development of the heart during the first 6 weeks of pregnancy.

According to the Centers for Disease Control and Prevention (CDC), some heart abnormalities may occur due to genetic changes or risk factors the person carrying the child came into contact with while pregnant. Examples of such risk factors include:

  • certain environmental factors
  • certain foods and beverages
  • certain medications

An ACA rarely causes symptoms. If symptoms are present, they may differ according to the type of ACA.

Possible symptoms of an ACA include:

Chest pain and other symptoms indicate that a person’s heart may not be receiving enough blood.

Symptoms may develop in childhood or adulthood. Those that present in later life may be due to the blood supply no longer being enough to support the adult body.

As an ACA does not typically cause symptoms, doctors often discover the condition incidentally while screening for or diagnosing other health issues.

If symptoms of ACA are present, it is essential to identify and treat the cause as soon as possible before complications arise.

Doctors can use various imaging techniques for diagnosing ACA, including:

  • Echocardiography: This involves using an ultrasound scan to view the heart and nearby blood vessels.
  • Catheter angiography: This involves injecting a contrast dye into the blood vessels to detect blood vessel abnormalities via X-ray imaging.
  • Coronary CT angiography (CCTA): A CT scan that looks at the coronary arteries.
  • MRI: A technique that uses magnetic resonance imaging to detect abnormalities.

Although the incidence of ACA is typically low, doctors are reporting an increase in cases. This may be due to the increased use of CCTA, which has become the standard of care among people experiencing chest pain.

The treatment for ACA depends on the type of abnormality. Most coronary artery anomalies are benign, incidental findings that do not require treatment.

In some cases, healthcare professionals may recommend that a person avoids strenuous exercise and begins taking medication, such as beta-blockers.

Doctors may recommend surgery for people with high risk anomalies to fix the anomaly and help prevent a heart attack or sudden cardiac death.

There is nothing a person can do to prevent an ACA. The condition is typically present from birth.

Because most people with ACA are asymptomatic, they may not even be aware that they have the condition.

Anyone concerned about the possibility of an ACA can request to undergo screening. If an ACA is present, they can talk with their doctor about taking steps to maintain their cardiovascular health and help prevent complications.

Most ACAs are benign and do not cause symptoms. As such, the outlook for people with an ACA is typically good.

Now that screenings are becoming more commonplace, doctors are detecting and treating ACAs before they have the chance to cause serious adverse events.

People who have received a diagnosis of an ACA should make sure that they follow their healthcare team’s recommendations.

An ACA is an abnormality within a coronary artery, which is an artery that delivers blood to the heart. Most ACAs do not cause symptoms. If symptoms are present, they may differ according to the type of abnormality. Possible symptoms include a fast heartbeat, shortness of breath, and fainting.

The incidence of ACA is rare, occurring in around 1% of the population. Since most people with an ACA are asymptomatic, doctors detect most cases during medical investigations for other health conditions.

There are many types of ACA, and they may each impact people differently. People should speak with a healthcare professional if they experience symptoms associated with the condition.