Anomalous Coronary Arteries/Fistulas

Symptoms

Many children with this type of defect won’t have any symptoms. Some will have symptoms like chest pain (angina) or fainting (syncope) with exercise. In rare circumstances, the abnormality can result in sudden death. Infants with anomalous left coronary artery arising from the pulmonary artery (ALCAPA) may become sick, with difficulty feeding and increased work of breathing within the first few months of life due to progressive deterioration of heart function. This requires surgery to remove the coronary artery from the pulmonary artery and reattach the vessel to the aorta. Because there’s usually some damage to the heart caused by the reduced blood flow to the heart, the squeezing function of the heart may be reduced. The function of some valves letting blood into the heart may be affected, resulting in significant valve leakage. Even after reattaching the anomalous coronary artery back to the heart, the squeezing function of the heart and valve function may not recover, resulting in cardiomyopathy (inflamed heart muscle).