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Coronary Anomalies

What Are Anomalies of the Coronary Arteries?

Congenital coronary artery anomalies are a rare class of congenital heart defects involving an abnormality of the origin and/or course of the coronary arteries, which are the blood vessels that supply the muscle of the heart.

The coronary arteries are small blood vessels that give blood supply to the heart itself. They normally arise from the very first part of the aorta, the main artery that delivers blood to the body. There are normally a left and right coronary artery and then the left coronary artery then divides into two arteries after it leaves the aorta. Anomalies of the coronary arteries are any arrangement of the coronary arteries that differs from the normal arrangement.

The coronary arteries can arise from an abnormal part of the aorta. Typically, the left coronary artery comes off the aorta close to the right coronary artery or vice versa. Because of multiple factors, this can lead to decrease blood flow to the heart muscle. This can lead to symptoms.

The coronary arteries can also arise from other abnormal locations. This can include the pulmonary artery, the main artery that gives blood from the heart to the lungs. The pressure in the pulmonary artery is lower than the aorta, so this coronary connection to the pulmonary artery can steal blood away from the heart and into the lung arteries.

In severe cases, these anomalous coronaries can cause the heart to weaken and make your child very sick. Decreased blood flow to the heart muscle can lead to the heart not functioning well, and it can eventually fail. If uncorrected, or corrected late, anomalous coronary arteries can lead to death.

What Are the Signs and Symptoms Anomalous Coronary Arteries?

Patient with congenital coronary artery anomalies may be asymptomatic, and some may have symptoms, including:

  • Chest pain
  • Loss of consciousness
  • Palpitations
  • Dizziness with exercise

How We Diagnose and Treat Anomalies of the Coronary Arteries

The initial evaluation of the coronary artery anomaly starts with an electrocardiogram, a machine records the electrical activity of your heart with a pen and graph paper, and transthoracic echocardiography, a still or moving image of the internal parts of the heart using ultrasound. The affiliated team at the Children’s Heart Institute at Children’s Memorial Hermann Hospital may ask you to send any previous medical records from outside facilities before your scheduled clinic visit. This helps our team review the records before the first clinic visit.

Coronary artery anomaly evaluation may also involve advanced imaging with cardiac computed tomography (CT) for better visualization of the coronary arteries and cardiac magnetic resonance imaging (MRI) to evaluate the blood flow to the heart muscles and to assess for any scar in the heart muscle. Once the diagnosis is confirmed, patients may need exercise stress test to evaluate the impact of coronary artery blood flow during activity.

Once all the testing is completed, we will discuss the coronary artery anomaly diagnosis and what it means for your child and your family as well as outline potential management options based on the most up-to-date information.

Depending on the information we have at the time of your visit, we may ask you to return for a follow-up visit in 1 to 2 months in order to allow for review of all the information with the entire team and for the development of the best management strategy. Once the best management strategy is formulated, you will be contacted by one of our team members to discuss the plan of care.

Why Choose Children’s Memorial Hermann Hospital?

The Children’s Heart Institute at Children’s Memorial Hermann Hospital earned the three-star rating, the highest possible distinction, from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in congenital heart surgery. As one of only 10 three-star programs of the STS’s 118 participating programs, the Children’s Heart Institute ranks among the elite in the United States and Canada for congenital heart surgery.

Children’s Memorial Hermann Hospital is recognized as one of the top 50 best children's hospitals nationally in Cardiology & Heart Surgery by U.S. News & World Report. Children’s Heart Institute, in collaboration with pediatric sub-specialists at McGovern Medical School at UTHealth, provides comprehensive care for newborns and children, with the ability to transition into adult congenital cardiac care.

Contact Us

Pediatric Cardiology Clinic
The University of Texas Health Science Center Professional Building
6410 Fannin, Suite 370
Houston, TX 77030
Phone: (713) 486-6755 (Appointment Line)

Pediatric and Congenital Heart Surgery Clinic
The University of Texas Health Science Center Professional Building
6410 Fannin, Suite 370
Houston, TX 77030
Phone: (713) 500-5746

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