Anomalous Coronary Arteries/Fistulas

Overview

Anomalous coronary arteries are rare and result when the arteries that supply the heart with blood (coronary arteries) don’t come from the usual location on the large artery that arises from the heart (the aorta). The normal branching patterns of the coronary arteries may be abnormal as well. Suppose the course of one of the major coronary arteries runs between the two major vessels leaving the heart (the aorta and the pulmonary artery). In that case, pinching the coronary artery is possible, which reduces blood flow back to the heart muscle. These pinched coronary arteries are benign, but some can be dangerous. It’s possible for one of the coronary arteries (typically the left) to arise from the artery supplying the lung (pulmonary artery) rather than directly from the aorta. An increased incidence of anomalous coronary arteries is associated with certain congenital heart disease (CHD) types.

Coronary fistulas are branches from the coronary arteries that bypass the small circulation of the heart muscle and pass directly back to one of the heart chambers or pulmonary arteries. These are sometimes found incidentally if a baby or child receives an echocardiogram for another reason. Sometimes, there’s enough blood flow through a fistula to create a heart murmur.