Background: Many types of anomalous coronary artery have been reported. Some forms of the anomaly are potentially malignant and can lead to sudden death.
Objective: To determine the prevalence and characters of anomalous coronary artery, including the associations of myocardial ischemia.
Material and Method: This is a retrospective study. The authors enrolled patients who were referred for cardiac magnetic resonance (CMR) and had magnetic resonance coronary angiography (MRCA) images. Imaging of the coronary arteries was acquired. The presence and patterns of anomalous coronary artery and the presence of myocardial ischemia was recorded. Myocardial perfusion study was also performed in most patients using adenosine stress test.
Results: Anomalous coronary artery was detected in 56 out of 3,703 patients (1.51%). There were 24 men (42.9%). Average age was 62.1+15.0 years. Most common type was right coronary artery (RCA) from left coronary cusp. Malignant form was demonstrated in 31 patients (55.4%) and myocardial ischemia was detected in 10 patients (23.3%).
Conclusion: Prevalence of anomalous coronary artery was 1.5%. Most common types were RCA from left coronary cusp (30%) and high take-off RCA (30%).

Keywords: Anomalous coronary artery, Myocardial ischemia, Sudden death