# Anomalous Coronary Artery Origin from Pulmonary Artery and Coronary Fistulas: A Review About Coronary Steal Phenomenon

## TL;DR

This review explains how abnormal coronary artery connections cause heart issues in children and how they are diagnosed and treated.

## Contribution

The paper provides a comprehensive review of the pathophysiology, diagnosis, and treatment of coronary anomalies causing coronary steal phenomenon.

## Key findings

- Anomalous coronary artery origin and coronary–pulmonary fistulas are major causes of ischemic cardiopathy in children.
- These anomalies share a similar pathophysiology but differ in embryology, anatomy, and clinical presentation.
- The review emphasizes the importance of tailored diagnostic and therapeutic strategies for these anomalies.

## Abstract

Anomalous coronary artery origin from pulmonary artery and coronary–pulmonary fistulas are the major causes of ischemic cardiopathy in children. Both anomalies are characterized by a connection between a higher and a lower pressure chamber causing coronary steal. However, several mechanisms and associated lesions may be responsible of the different presentations of the “coronary steal phenomenon”. The aim of this review is to highlight the different embryology, anatomical features, clinical presentation, and the diagnostic and therapeutic strategy of these coronary anomalies, despite their similar pathophysiology.