Congenital Coronary Artery Anomalies

Frommelt, Peter C.

doi:10.1007/978-1-84800-064-3_14

Cited by 9 publications

(10 citation statements)

References 79 publications

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“…However depending on the locations and types, these could be very important since they can cause myocardial infarction, effort‐related syncope, myocardial dysfunction, congestive heart failure, and sudden death. It is very important for pediatricians to know and be reminded of these risks which are higher in childhood and adolescent periods 1 . Coronary anomalies in the pediatric period are mostly related to Kawasaki disease, familial hypercholesterolemia, William's syndrome and congenital heart diseases, such as supravalvular aortic stenosis, ventricular septal defect, and pulmonary stenosis, although they could also be isolated 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Coronary anomalies in the pediatric period are mostly related to Kawasaki disease, familial hypercholesterolemia, William's syndrome and congenital heart diseases, such as supravalvular aortic stenosis, ventricular septal defect, and pulmonary stenosis, although they could also be isolated 3 . The main clinical sign of the congenital or acquired coronary artery anomalies is the myocardial ischemia, depending on a decrease or impairment of coronary artery perfusion 1 . Cerebral ischemia and seizures can be seen in patients depending on the extent of myocardial ischemia or rhythm disorders and can be confused with epileptic seizures.…”

Section: Discussionmentioning

confidence: 99%

“…Although isolated congenital coronary anomalies are seen rarely in children (1% of all child patients undergo coronary angiography), this disorder has great importance because of its potential effects 1 . Isolated stenosis or atresia of the left coronary artery ostium is extremely rare 2 .…”

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confidence: 99%

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A rare cause of cardiac syncope mimicking epilepsy: Left main coronary artery stenosis

Ergül¹,

Nişli²,

Aydoğan³

2011

Pediatrics International

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Key words children, epilepsy, left main coronary artery stenosis, syncope.Although isolated congenital coronary anomalies are seen rarely in children (1% of all child patients undergo coronary angiography), this disorder has great importance because of its potential effects. 1 Isolated stenosis or atresia of the left coronary artery ostium is extremely rare. 2 Clinically, this can present in late childhood with myocardial infarction, ventricular tachycardia, chest pain, syncope or sudden death, while growth retardation and cardiac failure can be seen at infancy. 3 We report a patient diagnosed with isolated stenosis of the left main coronary artery (LMCA) ostium that presented with recurrent effort-related syncope and generalized tonic-clonic convulsions and was treated with antiepileptic agents as she was thought to suffer from epilepsy. No previous pediatric case has been reported where a misdiagnosis of epilepsy was made in a patient with coronary anomaly. This case emphasizes the role of accounting for coronary artery anomalies in the differential diagnosis of children who have a history of effort-related syncope and seizure. Case reportAn 8-year-old girl presented with recurrent syncope and seizures. Her family reported that initially the generalized tonic-clonic convulsions lasted 10 min and started while playing around in the morning four years earlier and was later accompanied by urinary incontinence. It was noted that oral secretions and cyanosis occurred during the seizure and vomiting occurred after waking. Valproic acid was initiated, considering the diagnosis as epilepsy. Due to the recurrent nature of the seizures, several studies including electroencephalogram (EEG), biochemistry, and cranial magnetic resonance imaging were ordered, and all remained negative. Because the patient's complaints continued one more EEG was performed and although no pathological results were seen clonazepam was added to the valproic acid that had been taken for one year. While taking history about her latest seizure, the family reported that all the seizures were related to effort. The patient was then referred to our center. No metabolic, cardiac or neurological disorders were noted in the family history. No other abnormality was detected during physical examinations including detailed cardiovascular and neurological examinations at which neuromotor and growth percentiles were normal.The complete blood count, serum biochemistry, serum lipid profiles and cardiac enzymes were normal in laboratory findings. No cardiomegaly was detected on chest X-ray. The 12-lead electrocardiogram ( Fig. 1) and 24-hour Holter electrocardiogram were normal. Cranial magnetic resonance imaging and sleep/ awake EEG were applied and no pathology was detected. Two dimensional, M mode, colored and tissue Doppler echocardiography results were normal. Because the complaints were related to effort an exercise test was applied. On the effort electrocardiogram, T-wave negativity was detected on DII and DIII derivations. Cardiac computed tomography (CT...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A rare cause of cardiac syncope mimicking epilepsy: Left main coronary artery stenosis

Ergül¹,

Nişli²,

Aydoğan³

2011

Pediatrics International

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“…Historically, coronary artery anomalies have been defined and described according to an elaborate anatomic classification system . However, there has been a growing emphasis on categorization of coronary artery anomalies according to prognostic significance, specifically the increased risk of malignant arrhythmias and sudden cardiac death associated with certain subsets . Clinically significant coronary arterial anomalies may be classified into 2 basic anatomic subsets: those with origin of the anomalous coronary artery from the opposite aortic sinus, and those with origin of the anomalous coronary artery from the pulmonary artery (PA).…”

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

“…A coronary artery originating from the PA is much more rare, occurring in about 1 in 300 000 cases, more commonly involving the LCA originating from the main PA . These patients often present early in life with signs of congestive heart failure, dilated cardiomyopathy, and mitral regurgitation.…”

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

Coronary Arterial Development: A Review of Normal and Congenitally Anomalous Patterns

Lluri¹,

Aboulhosn²

2014

Clinical Cardiology

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Coronary artery development is a delicate, complex, and finely tuned process that includes multiple interactions among many pathways, especially in the pericardium and the developing myocardium. There still exists some controversy on the exact origin of certain cellular components. Nevertheless, an understanding of this extremely important developmental process is paramount in identifying some of the causes of anomalous coronary development. There are different patterns of anomalous coronary arteries, with variable risk of myocardial ischemia, malignant arrhythmias, and sudden cardiac death. These anomalies can be broadly categorized into 2 basic anatomic subsets: those with origin of the anomalous coronary artery from the opposite aortic sinus, and those with origin of the anomalous coronary artery from the pulmonary artery. Diagnosis and management of such patterns continues to be challenging. A good knowledge of the normal and abnormal coronary artery development could potentially help us explore new avenues in the treatment of ischemic heart disease as well as anomalous coronary arteries.

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Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Moradian

2021

Atlas of Echocardiography in Pediatrics and Congenital Heart Diseases

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Congenital Coronary Artery Anomalies

Cited by 9 publications

References 79 publications

A rare cause of cardiac syncope mimicking epilepsy: Left main coronary artery stenosis

A rare cause of cardiac syncope mimicking epilepsy: Left main coronary artery stenosis

Coronary Arterial Development: A Review of Normal and Congenitally Anomalous Patterns

Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA)

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