Coronary Artery Anomalies in Animals

Brian A. Scansen

Background: Coronary artery anomalies (CAA) in animals, are congenital defects of the origin, course, or structure of the coronary arteries that supply blood to the heart muscle. The article aims to raise awareness and improve understanding of such defects, which can range from incidental to life-threatening.

Study: The article provides a comprehensive overview of the coronary artery development, anatomy, and reported anomalies in domesticated species, especially dogs, hamsters, and cows. The article also suggests a categorization scheme for CAA in animals, dividing them into those of major or minor clinical significance. The article describes four novel canine examples of CAA with anomalous aortic origin, as well as some cases of coronary arterial fistulae and myocardial bridging in various species.

Methods: The article is based on a literature review of previous reports of CAA in animals, as well as the author’s own experience and observations from post mortem specimens, echocardiography, selective angiography, computed tomography (CT), and magnetic resonance imaging (MRI). The article also compares and contrasts the CAA in animals with those in humans, and discusses the diagnostic and therapeutic implications of CAA in veterinary medicine.

Results: The article summarizes the main types and features of CAA in animals, and provides illustrative examples with photographs, angiograms, and schematic drawings. The article highlights the importance of recognizing and characterizing CAA in animals, especially in the setting of congenital heart disease or pulmonary valve stenosis, as they may affect the prognosis and treatment options. The article also emphasizes the need for caution and expertise in diagnosing CAA by echocardiography, and recommends cross-sectional imaging or angiography for confirmation. the most common type of CAA in dogs is the single right coronary ostium with an anomalous prepulmonary left coronary artery. This CAA has been reported in several dogs, especially in brachycephalic breeds such as English bulldogs and boxers. It is often associated with pulmonary valve stenosis, which may limit the treatment options and increase the risk of complications. This CAA is also known as R-II-A anatomy, according to the Lipton classification

Limitations: The prevalence and pathogenesis of CAA in animals are difficult to estimate, due to the lack of routine diagnostic coronary arteriograms and the variability in the definition and classification of CAA. The clinical significance and risk of sudden death associated with CAA in animals are not well established, and that further studies are needed to elucidate the natural history and optimal management of CAA in animals.

Conclusions: The article concludes that CAA are observed in nearly all domesticated species, both in isolation and in association with concurrent congenital heart disease. The article states that understanding the anatomy, terminology, and clinical implications of CAA are important both in the treatment of veterinary patients and in serving as potential models for understanding CAA in humans5. The article also suggests that as the diagnostic capabilities available to veterinary cardiologists improve, more anomalies of the coronary arterial circulation will be found6.

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