Anomalous Coronary Artery in Children
anomalous coronary artery (ACA) is a heart defect. This is something your baby is
with (congenital). In ACA, the blood vessels that supply blood to your child’s heart
muscle aren’t normal. In some cases, the arteries don't arise from the correct place,
there are other problems with size or connections
vast majority of ACAs usually aren’t diagnosed until a person is a teen or adult.
is because the condition doesn’t cause many symptoms. It may also be hard to tell
an ACA is causing the symptoms. A specific type of ACA may occur in young babies.
type of ACA is called anomalous left coronary artery from the pulmonary artery
congenital heart problems have no known cause. An ACA may happen with other congenital
heart problems. For instance, it may occur with transposition of the great arteries
(TGA) and tetralogy of Fallot (TOF).
symptoms of an ACA vary depending on the defect. Your child may not have any symptoms.
In fact, people often don’t know they have this issue until they have a heart test
later in life for other reasons. Other people may have chest pain when exercising
Depending on the type of ACA, symptoms may start in babies. A baby with an ACA may have
chest pain from a decreased blood supply to the heart muscle (angina). Your baby may
- Irritability or fussiness
Your baby may also have symptoms of heart failure. These can include:
- Trouble breathing
- Swelling of the legs, ankles, feet, or other areas
An older child may complain of chest pain, dizziness, and fainting during exercise.
Older children may have symptoms of heart failure. These can include shortness of
breath with exercise and swelling of the legs, ankles, and feet.
People with an ACA may not have symptoms until adulthood. These can include chest
pain and symptoms of heart failure. Symptoms may start because of a decreased blood
supply to the heart muscle. There may have been enough blood supplied to the heart
muscle when they were younger. People may also have sudden cardiac death before the
condition is diagnosed.
symptoms of an ACA may look like other health issues or heart problems. Make sure
child sees their healthcare provider for a diagnosis.
child's healthcare provider will give your child an exam. They will listen to your
child’s heart and lungs, and look for other symptoms.
child's healthcare provider will refer your child to a pediatric cardiologist. This
doctor with special training to diagnose and treat heart problems in babies and
children. Your child's doctor may advise other tests such as:
A chest X-ray shows your child’s heart and lungs. The X-ray may show changes in the
lungs because of extra blood flow.
An ECG records the electrical activity of the heart. It also shows abnormal rhythms
(arrhythmias) and findings, including heart muscle stress (dilation or
An echo uses sound waves to make a moving picture of the heart and heart valves.
Cardiac catheterization (cardiac or heart cath)
cardiac catheterization gives detailed information about the structures inside the
heart as well as blood vessels connected to the heart. In this test, a small, thin,
flexible tube (catheter) is put into a blood vessel in your child’s groin. Then your
child’s healthcare provider guides it to your child’s heart. Your child will get an
injection of contrast dye. This is used to see the heart more clearly. Your child’s
healthcare provider will give them medicine to help relax and prevent pain
(sedation). Your child’s blood pressure and oxygen levels will be checked during the
Cardiac computed tomography angiography (CCTA)
CCTA shows detailed pictures of the blood vessels.
Cardiac magnetic resonance angiography (CMRA)
This type of MRI shows blood flow through the arteries of the heart.
This test uses dye and special X-rays to see the arteries of the heart.
These are scans that find abnormal blood flow to the heart. It can find how much the
heart is damaged. It can also measure heart function.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is and what type of ACA your child has.
Treatment for an ACA may include:
Medicines. Your child may take medicines to help the heart pump better pump
and to control blood pressure. Your child may also need oxygen therapy.
Surgery. Your child may need surgery to fix the defect.
child may also need to limit their activities.
coronary arteries send blood to the heart muscle. Any problems with these arteries
lead to a heart attack or death.
people with an ACA don’t know they have it until a severe event happens. These can
include chest pain, a heart attack, syncope (passing out) or sudden death.
Children with an ACA who are active or athletic may be at risk for sudden death. They
may need to change their exercise routines. ACA is the second most common cause of
sudden death in young athletes.
may also increase the risk for early fatty buildup inside the arteries of the heart
(coronary artery disease). This increases the risk for a heart attack.
with your child’s healthcare provider to create a care plan. Your child should follow
closely. Even if your child doesn’t have symptoms, they will need heart checkups.
child may also need exercise stress tests to check for changes in the coronary
your child has surgery for an ACA, they may still have a higher risk for early heart
disease. Ask your child's healthcare provider about your child's diet and physical
activity. This can help reduce your child’s risk for heart disease.
Ask your child's healthcare provider about your child’s outlook.
When to Call a Healthcare Provider
Call your child’s healthcare provider if your child has any new or worse symptoms.
If your child has chest pain, get medical help right away. This is an emergency.
- In an
ACA, the blood vessels that supply blood to the heart muscle aren’t normal or are
- ACAs are present at birth. But they are usually not diagnosed until the late teen
years or adulthood. This is because they don't often cause symptoms.
- This condition may lead to a heart attack or sudden death.
- If your child has chest pain, get medical help right away. This is an emergency.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the
visit, write down the name of a new diagnosis and any new medicines, treatments, or
tests. Also write down any new instructions your provider gives you for your
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.