Anomalous coronary artery

Like other parts of the body, coronary arteries differ from person to person. They don’t start in exactly the same location or follow identical paths as they wrap around the heart. But when something about a coronary artery is so different that it happens in fewer than 1% of people, it’s considered to be an anomalous (abnormal) coronary artery.

At Advocate Children’s Heart Institute, your child will be treated by a coordinated team of specialists and subspecialists who have experience in diagnosing all kinds of rare and complex heart conditions – including anomalous coronary arteries.

Anomalous coronary artery symptoms

Anomalous coronary arteries may be discovered shortly after birth if the baby shows signs and symptoms of a heart condition. The symptoms of each type of anomalous heart arteries are different depending on whether the anomalies affect the size, shape, origin, path or ending of the arteries.

Some of the signs and symptoms that may point to anomalous coronary arteries in young children are:

• Shortness of breath
• Paleness
• Crying while feeding
• Failure to thrive (a condition where a baby fails to gain enough weight or height)
• Congestive heart failure
• Heart murmur
• Abnormal heart rhythm (arrhythmia)

Symptoms may also resemble those of other heart diseases or medical conditions. Anomalous heart arteries are often not diagnosed until adolescence or adulthood because they didn’t cause symptoms until then.

Among older children or adults, anomalous coronary arteries may be discovered during screenings for other conditions. They may have similar symptoms to younger children or symptoms such as chest pain, sudden cardiac arrest, heart attack or heart failure.

If your child has serious chest pain or you think they might be having a heart attack, call 911 or take them to an emergency room immediately.

How serious is an anomalous coronary artery?

Having an anomalous coronary artery is very rare, occurring in less than 1% of the population. For most people, anomalous coronary arteries aren’t serious enough to cause problems. However, some of these abnormalities may lead to the heart being deprived of oxygen or nutrients which can cause tissue death (necrosis).

Having anomalous heart arteries can also be a cause of cardiac arrest or sudden cardiac death at any age. It’s been found to be the second most common cause of sudden cardiac death among young athletes.

Not enough research has been done to know whether anomalous heart arteries contribute to other conditions over time. Also, since heart artery anomalies are different from each other, it’s hard to pin down the effects of any one type of these rare conditions.

Anomalous coronary artery diagnosis

Your child may not be diagnosed with anomalous heart arteries at birth unless they have severe symptoms. To reach a diagnosis, your baby’s doctor will consult with specialists and recommend cardiac imaging and testing such as computed tomography (CT) angiography, electrocardiogram (EKG), echocardiogram, cardiac MRI or a stress test.

Anomalous coronary artery treatment

Treatments for anomalous coronary arteries depend on the details of the abnormality such as:

• Whether the defect is related to the right coronary artery or the left coronary artery
• Age, general health and medical history
• Expectations for what effects the defect will have

Some coronary vessel defects can be treated with nonsurgical methods including:

• Medications
• Oxygen therapy
• Activity limitations

Surgical treatment for anomalous coronary arteries

Cardiovascular surgery is sometimes recommended for babies and children with anomalies that may have serious effects. For example, a specific type of defect called anomalous left coronary artery from the pulmonary artery (ALCAPA) will usually require surgery because it can be fatal.

Surgery is recommended less often when the anomalous origin affects the right coronary artery. Anomalies of the left coronary artery are more serious.

Monitoring anomalous coronary arteries

Regardless of what treatment is recommended and whether your child has symptoms, they’ll need to be monitored at intervals to see whether their condition has changed. Your doctor will explain the extent of your child’s coronary vessel defects and their recommendations for treatment and continued monitoring.

Contact us with your questions about heart care for your child.

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