What Are Coronary Artery Anomalies?
Coronary artery anomalies weren't formed correctly before the birth. In most cases, the coronary artery is in the wrong place or coming from the wrong place. This problem can affect the left coronary artery, right coronary artery, left circumflex artery, and left anterior descending artery. Coronary artery anomalies may begin from the wrong part of the aorta, another artery, the pulmonary artery, or part of a different coronary artery.
What Are the Types of Coronary Artery Anomalies?
One of the common anomalies of coronary arteries is an artery that comes out of the wrong aortic sinus of the Valsalva. Usually, the right coronary artery will come out of the right aortic sinus of Valsalva, and the left coronary artery will come out of the left aortic sinus of Valsalva. Another type of anomaly is the coronary artery arising from the pulmonary artery instead of the aorta. This can sometimes affect the left or right coronary artery or rarely both. A rare form involves an accessory artery. Sometimes, the normal coronary artery can make up for what the abnormal coronary artery can’t do, so symptoms are absent in some individuals until they become adults.
What Are the Causes of Coronary Artery Anomalies?
The exact cause of the coronary artery is not known. The development of coronary arteries in the fetal heart has many steps, and if anything goes wrong in these steps, it can lead to coronary artery anomalies. Coronary artery anomalies are strongly linked to some of congenital heart diseases, including persistent truncus arteriosus, pulmonary valve atresia, transposition of great arteries, Double outlet right ventricle (DORV), and tetralogy of Fallot. Certain types of coronary artery anomalies can run in families, as shown in some studies. Still, doctors haven’t found a solid pattern to say for sure that coronary artery anomalies can be hereditary. In five percent of individuals, coronary artery anomalies are found who have undergone cardiac catheterization to find out the reason for having chest pain.
What Are the Risk Factors of Coronary Artery Anomalies?
As the coronary arteries supply oxygen-rich blood to the heart muscle, when the coronary artery has a defect or a disease, it might reduce the amount of oxygen and nutrients the heart receives. A lack of blood to the heart muscle, known as myocardial ischemia, can happen due to coronary artery anomalies and sudden cardiac death. If coronary artery anomalies are present in athletes or individuals who take part in strenuous activities, they are especially at risk of developing sudden cardiac death. In young athletes, coronary artery anomalies are the second leading cause of death. Sudden cardiac death, which is present between 15 and 34 percent of young individuals, is later found to have coronary artery anomalies. When there is a new story about young athletes dying suddenly, it is often due to those athletes having either hypertrophic cardiomyopathy or coronary artery anomalies.
What Are the Symptoms of Coronary Artery Anomalies?
Symptoms are not present in most of the cases of coronary artery anomalies. Symptoms can begin in childhood, while others may have symptoms until adulthood. The presence of the condition is not known in most individuals because they do not have symptoms at all or because of the sudden occurrence of cardiac death. Some of those that may include in babies with coronary artery anomalies are pale skin, breathing problems, sweating, and poor feeding. The symptoms present in adults are shortness of breath at rest or during exercise, fatigue, chest pain at rest or during exercise, and fainting during strenuous exercise, often the first and most dramatic symptom of coronary artery anomalies.
The most dangerous symptom of coronary artery anomalies is sudden cardiac death, and this happens due to the abnormal coronary artery getting squashed between larger arteries that will become stretched with blood during exercise. Due to this, less blood reaches the heart, which can lead to sudden death.
How Are Coronary Artery Anomalies Diagnosed?
Physical examination is performed by the doctors, and using the stethoscope, they will listen to the heart and lungs. Other tests for coronary artery anomalies are:
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Echocardiography: This test will show the heart size and amount of muscle damage present.
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Magnetic Resonance Imaging (MRI): This will give a detailed image of the heart, including coronary arteries, to check for any coronary artery anomalies. Magnetic resonance angiography will evaluate blood flow through the arteries.
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Angiography: A procedure known as cardiac catheterization is done to help get a detailed view of coronary artery anomalies.
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Transesophageal Echocardiography: This will help get a picture of the heart inside the esophagus rather than through the chest wall.
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Computed Tomography (CT): This will help to get a good picture of the coronary arteries by scanning, significantly electron beam computed tomography.
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Nuclear Imaging Tests: This test is done to see if the blood flow to the heart is abnormal and if the heart muscles are damaged.
How Are Coronary Artery Anomalies Treated?
Treatment for coronary artery anomalies includes medicines, lifestyle changes, percutaneous coronary interventions, and surgery.
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Medicines: To prevent sudden cardiac death in mild-to-moderate symptoms, medicines can be used, such as beta-blockers, which will slow the heart rate; antiarrhythmic medicines, which will help to regulate the heartbeat; diuretics to reduce excess fluid in the body, which will relieve the stress on the heart’s pumping action. Oxygen therapy will increase the amount of oxygen-rich blood reaching the heart.
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Lifestyle Changes: individuals with coronary artery anomalies must stay less physically active, avoid exercising too much, and participate in particular sports.
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Percutaneous Coronary Interventions: A stent is placed in the artery with coronary artery anomalies, which will help correct some coronary artery anomalies.
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Surgery: Surgery is sometimes performed to correct coronary artery anomalies.
Conclusion
Coronary artery anomalies aren’t dangerous in most individuals but can be dangerous in some. There are no symptoms in most of the individuals until they have a sudden cardiac arrest. There are several surgical options to protect from sudden death and help to lead an everyday life. Taking the medicines properly as the healthcare provider prescribes and getting regular checkups is essential.
