The primary concern with anomalous coronary arteries is the risk of sudden cardiac death (SCD), which can occur without warning. This risk is heightened during physical exertion due to factors such as:
Mechanical Compression: The coronary artery may be compressed between the aorta and pulmonary artery.
Vasospasm: Mechanical stimulation can cause the artery to constrict.
Ostial Occlusion: A slit-like orifice or acute-angle takeoff can obstruct blood flow.
Intramural Course: The artery may run within the aortic wall, increasing susceptibility to compression.