• Coronary Artery Fistula—Child

    Definition

    In a normal heart, the coronary arteries carry oxygen-rich blood to the heart tissue. The blood is then returned through a coronary vein. With a coronary artery fistula, the artery connects to a wrong part of the heart (eg, the heart chamber or other blood vessels).
    The Coronary Arteries
    si1902 the coronary arteries
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    This condition can be mild to severe. Other heart defects may be present as well.

    Causes

    This condition is typically a congenital defect. This means that the baby is born with it. It is not known exactly why the coronary artery develops abnormally in some babies. It can also occur after birth due to infection, injury, or heart surgery.

    Risk Factors

    For many congenital heart defects, the risk factors are unclear.

    Symptoms

    Children with this condition usually do not have any symptoms. Sometimes the condition is noticed by a heart murmur that the doctor hears during a physical exam. Occasionally, other symptoms may include:
    • Chest pain
    • Abnormal pulse
    If your child has any of these symptoms, get medical care right away. In severe cases, this condition can lead to a heart attack or a ruptured fistula.

    Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:
    • Echocardiogram —an imaging test that uses sound waves to look at the size, shape, and motion of the heart
    • Chest x-ray —an imaging test that uses low amounts of radiation to create an image of the chest
    • Electrocardiogram —a test that measures the electrical activity of the heart
    • Cardiac catheterization —a test that uses a catheter (tube) and x-ray machine to assess the heart and its blood supply

    Treatment

    Talk with the doctor about the best treatment plan for your child. Options include:

    Surgery

    Surgeries that may be done to treat this condition include:
    • Coil embolization —The defect may be closed through a catheterization procedure. A soft metal coil or clamp is placed to close the abnormal vessel.
    • Surgery—Surgery may be done to close the defect using stitches.

    Lifelong Monitoring

    Your child will have regular exams by a heart doctor.

    Prevention

    Preventing heart defects may not always be possible. However, getting regular prenatal care is always important.

    RESOURCES

    American Family Physician http://www.aafp.org/

    American Heart Association http://www.americanheart.org/

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca/

    Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/

    References

    American Heart Association. How your cardiologist diagnoses heart defects. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=152 . Accessed July 13, 2010.

    Children’s Hospital Boston. Coronary artery fistula. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/cfapps/mml/index.cfm?CAT=topic&TOPIC%5FID=1087 . Accessed July 13, 2010.

    Johns Hopkins University, Cove Point Foundation. Coronary artery fistula. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=coronaryfistula6 . Accessed July 23, 2010.

    Revision Information

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