Coronary artery anomaly

Chest | Cardiology | Coronary artery anomaly (Disease)


Coronary artery anomalies (or malformation of coronary vessels) are congenital abnormalities in the coronary structure of the heart. By definition, these abnormalities are variants of anatomy occurring in less than 1% of the general population. They are often found in combination with other congenital heart defects. Many coronary anomalies dont cause symptoms and are recognized only at the time of autopsy. This disorder accounts for 4%-15% of sudden cardiac deaths in young people.

Symptoms may not be present until the early teen years depending on the location and severity of the defect. Sometimes the first indication something is wrong is a life threatening event such as a heart attack or abnormal beating of the heart. Some do not cause symptoms and are discovered at autopsy.

The symptoms of ACA vary depending on the type of anomalous artery present. Some types have no associated symptoms and may be found later in life during diagnostic tests such as cardiac echocardiography (echo) or cardiac catheterization. Other types of ACA may cause symptoms related to decreased blood flow to the heart tissue, such as chest pain on exertion or at rest.

Causes and Risk factors

The vast majority of congenital heart defects have no known cause. A babys heart begins to develop at conception, and is completely formed by eight weeks into the pregnancy. Congenital heart defects develop during this crucial first eight weeks of the babys development. Specific steps must take place in order for the heart to form correctly. Often, congenital heart defects are a result of one of these crucial steps not happening at the right time.

ACA may be associated with other congenital heart defects, particularly transposition of the great arteries, tetralogy of Fallot, and certain forms of pulmonary atresia.

Diagnosis and Treatment

A history and physical exam are usually undertaken. Some tests to evaluate the function and structure of the heart and its blood vessels are also done.

Therapy will depend on the abnormality and the age of the child. Treatments may include: blood pressure medications, water pills, and oxygen. In some cases surgery may be necessary as well. ...