REVIEW IN DEPTH: PDF OnlyAnomalous coronary arteries and coronary artery fistulas In Infants and childrenKarr, Sharon S. MD; Giglia, Therese M. MDAuthor Information Department of Cardiology, Children's National Medical Center, Washington, DC, USA(Karr) The Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA(Giglia) Coronary Artery Disease: February 1993 - Volume 4 - Issue 2 - p 139-147 Buy Abstract Congenital coronary artery abnormalities are rare, occurring in only 1% to 2% of the population . When present, however, these abnormalities can result in significant morbidity and mortality. Congenital coronary artery abnormalities are associated with an increased risk of sudden death, infective endocarditis, ischemic cardiomyopathy, and they may be more likely to develop premature atherosclerosis. Congenital coronary artery abnormalities include anomalies of coronary origin or termination. Coronary arteries may originate anomalously from either the pulmonary artery or the aorta. Anomalies of termination (coronary arteriovenous fistulas) may occur in isolation or in association with congenital heart lesions. Because patients with coronary artery abnormalities frequently lack direct physical findings, a high level of clinical suspicion is imperative for accurate and timely diagnosis. © Lippincott-Raven Publishers.