If the doctor tells you that your child has a heart problem, you feel very scared and worried, right? It's very normal. But most of the time, some of these conditions are not as dangerous as we think. Today we are going to talk about a special condition that is caused by birth and is seen in the blood vessels of the heart. This is medically called Anomalous Coronary Artery . Let's talk about this simply, in a way that you can understand.
Simply put, what is an Anomalous Coronary Artery?
This is very simple to understand. Our heart is like a pump made of muscle tissue. This heart muscle needs clean, oxygenated blood to work. The blood vessels that supply that blood are called coronary arteries . Anomalous Coronary Artery is when one or more of these coronary arteries do not form properly when a child is developing in the womb.
Imagine what's happening here, like a water pipe in a house starting in the wrong place and connecting to the wrong place. These blood vessels don't start where they should, or they're not where they should be.
The types of arteries that can be primarily affected by this problem are:
- Right coronary artery
- Left main coronary artery
- Left circumflex artery
- Left anterior descending artery
The main thing that happens when this artery is in the wrong place is that it interferes with the normal flow of oxygen-rich blood to the heart muscle. This can cause the heart muscle to not get enough blood.
This condition may affect about 1% of the population. But remember, most of these cases are not dangerous. However, sometimes, it can cause complications due to reduced blood flow to the heart muscle.
Are there different types of this?
Yes, there are several main types of this condition. Let's look at it simply, without making it complicated.
- Without the main left artery, the other two arteries start directly from somewhere else. This is the most common type of this condition.
- An artery starts on the other side of the body instead of where it should. Normally, the left artery starts on the left side and the right artery starts on the right side. But in this case, it may have switched.
- Instead of starting from the main artery that carries oxygenated blood to the heart (the aorta), it starts from the artery that carries blood to the lungs (the pulmonary artery). This can be a very dangerous situation.
- Rarely, there are cases where an extra artery starts in the tube that carries blood to the lungs.
Sometimes, the normally located artery helps fill the role that the abnormal artery cannot do. This is why some people don't develop any symptoms until they are adults.
What are the symptoms of this condition?
The symptoms that appear can vary depending on the type of abnormality. Sometimes, the symptoms do not appear in young children, but in adults. Let's see this clearly in a table.
| Type of abnormality | Commonly seen symptoms |
|---|---|
| Artery that begins in the wrong place (AAOCA) | Many children have no symptoms. Sometimes the first symptom is a sudden cardiac arrest (SCA) that occurs during exercise. This risk is especially high in young people between the ages of 10 and 30.
|
| Right aorta originating from the pulmonary artery (ARCAPA) | Symptoms may appear at birth or between the ages of 40-60. |
| Left aorta originating from the pulmonary artery (ALCAPA) | This is a very serious condition. Symptoms usually appear in infancy, within the first year. |
What is the reason for this?
The exact cause of this has not yet been found. This is a congenital problem. This means that this condition occurs due to some defect that occurs when the coronary arteries of the heart are formed during the first month after conception.
The most important thing is that research has not proven that this is a hereditary disease. Therefore, do not think that this is your fault.
How does the doctor diagnose this disease exactly?
It can be a little difficult to detect because some people have no symptoms and everything looks healthy during a routine medical exam. However, if your doctor suspects this condition, he or she will recommend a few tests like this.
- CT Angiogram (Computed Tomography Angiogram): This can take three-dimensional (3D) images of the blood vessels of the heart and see exactly where the arteries are located.
- Chest X-ray
- Transthoracic Echocardiogram: A scan to look at the function and structure of the heart.
- ECG test (Electrocardiogram): A test to check the electrical activity of the heart.
- Heart MRI scan
- Cardiac Catheterization: A small tube is passed through the blood vessels into the heart to check the pressure and position of the arteries.
- Stress Test: Monitoring how the heart works during exercise.
What are the treatments for this?
Treatment depends on the type of abnormality, its severity, and whether or not there are symptoms.
For many people, especially young, healthy people who are asymptomatic, doctors recommend surgery to prevent future problems. Surgery is especially necessary for those with serious conditions, such as left atrial appendage (LAPA).
However, some types, for example minor abnormalities in the right atrium, may not require surgery unless there are symptoms.
If surgery is not an option, your doctor may tell your child to limit exercise and may also prescribe medications, such as beta-blockers, to reduce the workload on the heart.
There are several main types of surgery used:
- Bringing the artery back to its proper place and reconnecting it.
- Coronary unroofing.
- Pulmonary artery translocation.
- Coronary artery bypass grafting.
What will happen after the surgery and beyond?
After the surgery, the child will have to stay in the hospital for a few days. They may be asked to take medication such as aspirin for about three months. They are usually allowed to participate in sports again after three months.
Since this is a congenital condition, it is very important to have regular medical checkups throughout life, even if surgery is performed.
The outlook for someone living with this condition is generally good. Especially for a serious condition like ALCAPA, which has a 90% chance of being fatal if left untreated, it can be completely cured if detected early and treated properly . Surgery can relieve symptoms and prevent sudden death.
What time should I see a doctor?
You need to be very careful about these characteristics.
If your baby has these symptoms:
- If you are constantly crying for no reason.
- If the skin looks pale.
- If you feel like you are breathing too fast.
If you have these symptoms, see a doctor immediately.
If an adult:
If you have chest pain and difficulty breathing , go to the hospital's Emergency Treatment Unit (ETU) immediately. This could be a sign of a heart attack, so don't delay.
There are many emotions that come to mind when you find out that your child has a heart problem. But the best part is that this Anomalous Coronary Artery condition is usually harmless. Talk openly with your child's doctor about your child's condition. He or she will give you the advice you need. The most important thing is to send your child for regular checkups as your doctor recommends.
Take-Home Message
- Anomalous Coronary Artery is a congenital condition. It is not something that is caused by the parents' fault.
- Many people with this condition live normal lives without any symptoms.
- Never ignore symptoms such as chest pain or shortness of breath, especially when exercising. See a doctor immediately.
- If a baby cries frequently or has difficulty breathing while breastfeeding, be concerned.
- Correct diagnosis and treatment (often surgery) are very successful. So there is no need to be afraid.
- Follow your doctor's instructions carefully, especially regarding exercise restrictions and regular checkups.
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