Cor Vasa 2026, 68(3):340-348

Multimodality imaging of congenital coronary anomalies non-atherogenic coronary diseases

Marek Kardoš^a, Peter Olejník^b, Erika Drangová^{c, d}, Jana Poláková Mištinová^{c, e}

a Oddelenie funkčného vyšetrovania, Detské kardiocentrum, Bratislava, Slovensko

b Oddelenie detskej kardiológie, Detské kardiocentrum, Fakulta medicíny, Komenského Univerzita, Bratislava, Slovensko

c III. rádiologická klinika, LF UK a NÚSCH, a.s., Fakulta medicíny, Komenského Univerzita, Bratislava, Slovensko

d Oddelenie diagnostickej a intervenčnej rádiológie, NÚSCH, a.s., Bratislava, Slovensko

e MR oddelenie, NÚSCH, a.s., Bratislava, Slovensko

Coronary artery anomalies are very rare in the general population. They can occur as an isolated anomaly or

as part of congenital heart defects. Only 20% of them are potentially clinically significant and can manifest

with life-threatening symptoms such as myocardial ischemia, malignant ventricular arrhythmia, or sudden

cardiac death. They are usually detected as an incidental finding during CT or catheterization coronary

angiography. They represent the second most common cause of death in young athletes after hypertrophic

obstructive cardiomyopathy.

In this review, for simplicity and clinical relevance, we focus on the most common coronary artery anomalies

that may be clinically significant and require intervention, whether catheterization or cardiac surgery. We

also describe the strengths and weaknesses of individual modalities in coronary artery imaging. We pay

special attention to inflammatory diseases of the coronary artery wall of non-atherogenic origin, the main

representative of which in the pediatric population is Kawasaki syndrome.

Keywords: Congenital anomalies Coronary arteries Kawasaki disease Multimodality imaging

Received: November 17, 2025; Revised: February 24, 2026; Accepted: March 14, 2026; Prepublished online: June 2, 2012; Published: July 1, 2026  Show citation