Pediatric Coronary Artery Conditions

At Children's Health℠ The Heart Center, we specialize in diagnosing and treating rare coronary artery conditions that affect infants and children. We have the expertise to treat these conditions, helping your child enjoy an active, full life.


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What are Pediatric Coronary Artery Conditions?

Coronary artery conditions affect blood flow to the heart muscle. When there are problems with the coronary arteries, the heart muscle doesn’t get enough oxygen. Without treatment, some coronary artery conditions can lead to heart failure.

What are the different types of Pediatric Coronary Artery Conditions?

There are different types of coronary artery conditions. The causes, symptoms and treatments vary depending on the type.

Coronary artery conditions may:

Congenital anomalous coronary artery diseases

Congenital anomalous coronary artery diseases occur when the coronary arteries connect to the wrong places. An anomaly is something that is different than expected. Congenital coronary artery anomalies affect about 2% of people who have congenital heart disease. Children with these rare conditions receive advanced care at our dedicated Congenital Coronary Anomaly Program.

Congenital coronary artery diseases include:

Anomalous left coronary artery from the pulmonary artery (ALCAPA)

The left coronary artery connects to the pulmonary artery instead of to the aorta. This means oxygenated blood doesn’t get to some parts of the heart muscle, which increases the risk of heart failure. Symptoms appear within the first few months of life. Without treatment, an infant may have a heart attack.

Anomalous aortic origin of a coronary artery (AAOCA)

This condition occurs when both the left and right coronary arteries attach to the same side (either the left or right side) of the aorta. In a healthy heart, the left coronary artery attaches to the left side, and the right artery attaches to the right side. This condition may not cause symptoms, or a child may have chest pain and feel dizzy after exercise. It is the second leading cause of sudden cardiac arrests (unexpected stopping of the heart) in young people.

Acquired coronary artery diseases

Acquired coronary artery diseases are not present at birth. A child develops a problem later in life, usually after having some type of infection. Acquired conditions that affect the coronary arteries include:

  • Kawasaki disease - This condition inflames and weakens the coronary arteries. It increases the risk of blood clots, aneurysms (weak spots in an artery wall) and heart attack. Children often develop Kawasaki disease after having another illness, but there’s no known specific infection that causes the disease.
  • Multisystem inflammatory syndrome in children (MIS-C) - This condition affects a small number of children (typically between the ages of 5 and 13) who get COVID-19. For unknown reasons, the virus causes inflammation in the heart, lungs, kidneys or intestines.

What are the signs and symptoms of Pediatric Coronary Artery Conditions?

Symptoms vary depending on your child’s age and their condition. Children with anomalous aortic origin of a coronary artery may not have symptoms. Older children may have chest pain, dizziness or fainting during physical activity.

Infants may have:

  • Difficulty gaining weight
  • Pale or gray skin or lips
  • Rapid breathing

How are Pediatric Coronary Artery Conditions diagnosed?

At Children’s Health, your child sees heart doctors who are experts at detecting rare coronary artery conditions. We perform a thorough physical examination and use advanced cardiac imaging to accurately diagnose conditions that others may overlook or misdiagnose.

These tests produce images of the heart and blood vessels to help us make a diagnosis:

We may also use an exercise stress test in older children to check the function of the coronary arteries. This test shows how the heart responds to physical exertion.

What causes Pediatric Coronary Artery Conditions?

Congenital coronary artery conditions develop in the womb. For unknown reasons, an unborn baby’s heart or arteries don’t form as they should. Heart defects aren’t caused by anything a woman does or doesn’t do during pregnancy.

Infections from viruses or bacteria may cause acquired coronary artery conditions. Researchers are still trying to determine why some children develop Kawasaki disease or MIS-C while others don’t.

How are Pediatric Coronary Artery Conditions treated?

Treatments depend on the type of coronary artery disease. They include

  • Heart surgery to reposition the coronary arteries and improve blood flow and heart function. Surgery can prevent heart failure in children with congenital coronary artery conditions.
  • IV immunoglobulin (IVIG), infusions of antibodies (proteins), to help children with Kawasaki disease fight infections. A child may also get aspirin and steroids.
  • Medications and fluids to help children recover from MIS-C.

Pediatric Coronary Artery Conditions Doctors and Providers

Doctors at The Heart Center specialize in diagnosing and treating rare blood vessel disorders. For all coronary artery conditions, we use a team approach involving multiple heart specialists to help your child.

Frequently Asked Questions

  • What causes chest pain in a child?

    It’s common for a child to complain of chest pain. And most of the time, the cause isn’t a heart condition. Illnesses, stress or anxiety, pulled chest wall muscles and gastroesophageal reflux disease (GERD) can cause chest pain in a child. Your child’s doctor can perform an exam and order tests, if necessary, to determine the cause.

  • What causes a child to faint?

    Fainting is often a sign of poor fluid intake . Lack of fluids can lower blood pressure (hypotension), causing a child to faint. Fainting can also occur if a child is upset, such as during a blood draw or when they’re in pain. Less commonly, arrhythmias (unusual heart rhythms) or heart defects like coronary artery conditions make a child faint.

  • What type of follow-up care does my child need?

    A child diagnosed with any type of coronary artery condition should see a pediatric cardiologist throughout childhood for ongoing care. Even after treatments or surgery, problems may develop. Children with congenital problems may transition to our adult congenital heart disease program when the time comes.