Open Access
ARTICLE
Clinical evaluation of anomalous aortic origin of a coronary artery (AAOCA)
Silvana Molossi, Hitesh Agrawal
Coronary Anomalies Program, Division of
Pediatric Cardiology, Texas Children’s
Hospital, Department of Pediatrics, Baylor
College of Medicine, Houston, Texas, USA
* Corresponding Author: Silvana Molossi, Texas Children’s Hospital, 6621 Fannin St WT 19345-C, Houston, TX 77030. Email:
Congenital Heart Disease 2017, 12(5), 607-609. https://doi.org/10.1111/chd.12505
Abstract
The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a
congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is
challenging given its first presentation being sudden cardiac arrest in about half of the patients.
Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in
evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and
electrocardiogram further adds to the difficulty in establishing the diagnosis. Additional imaging
with echocardiography, computed tomography angiography and/or cardiac magnetic resonance
imaging (MRI) is often needed and establishes the diagnosis. High-risk lesions include origin of the
coronary artery from the opposite sinus of Valsalva, intramural course and ostial abnormalities
(stenosis, hypoplasia). Functional studies should be performed to assess myocardial perfusion at
rest and during stress, such as nuclear imaging, stress echocardiography and stress cardiac MRI.
Keywords
Cite This Article
Molossi, S., Agrawal, H. (2017). Clinical evaluation of anomalous aortic origin of a coronary artery (AAOCA).
Congenital Heart Disease, 12(5), 607–609. https://doi.org/10.1111/chd.12505