[Long-term clinical course in the anomalous origin of coronary arteries].

The authors analyze in a retrospective investigation the clinical picture of 15 adult patients (12 men and 3 women) with an abnormal origin of the coronary arteries, diagnosed from a total of 5500 coronarographic examinations made in the Institute for Clinical and Experimental Medicine. In four patients the anomaly was isolated and in 11 patients it was associated: in six with coronary disease, in three with rheumatic heart disease and in two with an atrial septal detect. The authors evaluate the long-term clinical course by check-up ambulatory examinations after time intervals of 64.6 +/- 45.7 months following the coronarographic examination. The long-term course was favourable in the four patients with the isolated anomalous origin of the coronary arteries. In patients with an associated anomalous origin of the coronary arteries and other heart disease the long-term course was not favourable. Two patients died, two suffered a myocardial infarction, one suffered from angina and one from cardiac dysrhythmia. The authors assume that the complications developed mainly due to the associated heart disease, congenital or acquired. The objective physical finding, ECG and X-ray finding of the heart and lungs did not change significantly in the meantime. It appears thus that an isolated anomalous origin of the coronary arteries may be a relatively benign disease. The prognosis of the patients depends above all on associated heart disease or other diseases.