Introduction
The coronary arteries, popularly known as coronary arteries, supply the heart with oxygen-rich blood. Immediately after the aortic valve, the two main branches of the coronary arteries emerge from the ascending part of the aorta. The left coronary artery mainly supplies the anterior wall of the heart and the right coronary artery supplies the posterior wall. Although some of the coronary arteries lie relatively superficially on the heart muscle, they also supply the heart in depth via smaller arteries. If the coronary arteries are impaired, e.g. as a result of arteriosclerosis, in the worst case this can lead to a heart attack and death.
Systematics of the coronary arteries
From the aorta emerge the arteriae coronariae dextra (right coronary artery) and sinistra (left coronary artery), which are divided into further branches as they progress. They originate from the left coronary artery: Originating from the right coronary artery: Both the left and right coronary arteries can give rise to a posterolateral ramus/RPL that runs along the back of the heart. This is followed by numerous other small branches that supply the heart muscle tissue comprehensively.
- Ramus interventricularis anterior/RIVA (English synonym: LAD/”left anterior descending”)
- Ramus circumflexus/RCX
- Ramus intermedius (does not always exist, but relatively often)
- Ramus interventricularis posterior/RIP
- Ramus marginalis dexter/RMD
The American Heart Association has divided the coronary arteries into 15 segments. Segments 1 to 4 correspond to the right coronary artery, while segments 5 to 10 are attributed to the left coronary artery. Segments 11 to 15 belong to the left circumflex ramus.
This subdivision can help in orientation (e.g. in the description of findings). An anomaly of the coronary arteries is a malformation that is present in about 1% of the population, usually since birth. Anomalies can be divided into anomalies of origin, orifice and course of the coronary arteries.
For example, one of the coronary arteries may originate at a different site of the aorta or even the pulmonary artery and have a different course to the area of supply. In most cases, they do not cause discomfort for a long time. If they do not pose a potential risk, such anomalies are called benign.
Malignant/malignant anomalies can cause symptoms such as heart stabbing or fainting and can even become life-threatening over time. In the worst case, they can lead to heart attack or even sudden death. They are often diagnosed accidentally. If you then want to take further steps to obtain an exact diagnosis, multi-line spiral computed tomography is the most sensible and most accurate imaging method. Depending on how the anomaly is then classified, i.e. whether it is benign or malignant, further treatment options to prevent a cardiological event can be discussed and initiated.
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