Major coronary anomalies in childhood.
Major coronary artery anomalies are extremely rare in childhood. We wanted to assess the historical and diagnostic features and the therapeutic options of three distinct types of coronary artery anomalies: abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA), coronary fistula and coronary stenosis. In a retrospective study, 33 children with these types of coronary artery disease were identified, 15 with ALCAPA, 12 with fistula and six with coronary stenosis. History, physical examination, ECG, X-ray, echocardiography, angiography, therapy and outcome were reviewed. ALCAPA showed distinct typical echocardiographic characteristics. Coronary artery fistula could be identified by a typical murmur and echocardiographic evidence of coronary dilatations. Coronary stenosis should be suspected by the clinical picture in a specific context.


CONCLUSIONS
rare coronary artery anomalies can be accurately diagnosed in childhood. Timely therapy yields good prognosis.
De Wolf
Daniël
D
Department of Paediatric Cardiology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. daniel.dewolf@rug.ac.be
Vercruysse
Tom
T
Suys
Bert
B
Blom
Nico
N
Matthys
Dirk
D
Ottenkamp
Jaap
J
D002675:Child, Preschool; D023921:Coronary Stenosis / Q000175:diagnosis; D003328:Coronary Thrombosis / Q000175:diagnosis; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities; D012189:Retrospective Studies; D014463:Ultrasonography