冠状动脉粥样硬化性心脏病（冠心病）的萌芽状态早在胎儿发育期已经开始。胚胎期是人类生长发育的重要时期，并对成人冠心病的预防和发生起着关键作用。在众多导致冠心病发病的因素中，胎儿宫内生长情况及遗传因素受到了广泛关注。胎儿生长受限可造成重要器官营养缺乏，同时扩血管因子功能失调将损伤心血管系统，进而造成新生儿低出生体质量，可能进一步打破后天机体的代谢平衡，最终导致中老年期冠心病的发生。然而，遗传因素作为独立的风险因子，贯穿了人类生长发育的整个过程，包括冠心病易感基因位点以及与之伴随的家族史，对冠心病的程序性发生起着主导作用。现从胚胎期冠状动脉各种形式的异常发育、子宫内因素对胚胎发育及后天生长的影响，以及冠心病多种易感位点的遗传因素等方面共同阐述胚胎发育与成人冠心病发生的相关性。“,”Coronary artery disease( CAD) accounts for over half of all cardiovascular deaths worldwide.Recent evidence has shown that embryonic development is important in the occurrence of coronary events later in a person’ s life.Factors such as intrauterine growth and genetic factors contribute to CAD.This article summarizes those coronary artery anomalies in the embryo, the detrimental factors in fetal growth, and the related susceptibility loci that control embryo growth and ultimately result in CAD in adulthood.