Coronary Artery Fistula—Child

  • Definition

    Coronary artery fistula is an abnormal connection between the coronary artery and the heart or other blood vessels. Coronary arteries carry oxygen-rich blood to the heart tissue. A small fistula will not affect this blood flow, but larger fistulas may cause problems.
    The Coronary Arteries
    si1902 the coronary arteries
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  • Causes

    This condition is typically a congenital defect. This means that a baby is born with it. It is not known exactly why the fistula develops.
    Some fistulas can also occur after birth due to infection, injury, or heart surgery.
  • Risk Factors

    The risk factors for coronary artery fistula is unclear.
  • Symptoms

    Children with this condition usually do not have any symptoms.
    A large fistula may cause chest pain, an irregular heart beat, or an abnormal pulse, but this is rare. If your child has any of these symptoms, get medical care right away. In severe cases, this condition can lead to a heart attack, heart failure, or a ruptured fistula.
  • Diagnosis

    You will be asked about your child’s symptoms and medical history. A physical exam will be done. A coronary artery fistula may be suspected if a heart murmur is heard during a physical exam.
    Images may be taken of your child's bodily structures. This can be done with:
    Your child's heart function may be tested. This can be done with:
  • 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 —A special coil is passed through blood vessels in the arms or legs to the heart. The coil can close off the abnormal vessel.
    • Open heart surgery—to close the defect with stitches.
    Lifelong Monitoring
    Your child will have regular exams by a heart doctor. This is done to prevent major complications.
  • Prevention

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

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

    Family Doctor—American Family Physician http://www.familydoctor.org

    CANADIAN RESOURCES

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

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

    References

    Coronary artery fistula. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1748/mainpageS1748P1.html. Accessed May 29, 2014.

    Coronary artery fistula. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=coronaryfistula1. Updated May 16, 2011. Accessed May 29, 2014.

    Lin C-T, Lin T-K. The current status of coronary artery fistula. J Intern Med Taiwan. 2009;20:484-489.

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