Heart Information Center
 
Ask a Heart Doctor
  Back to previous page

 

Help us improve this service.

Your feedback will help guide us in developing this site.

Ask a Texas Heart Institute Doctor 
Informed patients make better patients.

Question:

How do you approach management of anomalous right coronary arteries?

My 11 year old daughter and husband have both been diagnosed with anomalous right coronary arteries originating from the left sinus of Valsalva (apparently genetic in our family). My daughter was an athlete until she was diagnosed. She is asymptomatic - it was a fluke that we found it. We have seen 3 cardiologists each with a slightly different perspective on how to proceed with her treatment. Basically, we can let her lead a normal, active life knowing she has about a 1 in 1000 chance she'll have a cardiac event doing it; eliminate sports; or surgically correct it. My question to you is: what is the general recommendation you give an asymptomatic, athletic child with this abnormality? Do you have any protocol you follow?

I should mention that she has had a stress test and 2 ECG's which were normal. Her echo and CTA just showed the anomalous artery, no other problems. There has been a difference in opinion as to whether it is intramural or not and how much compression there is at the ostium, but per the cardiologists here, there is no way to analyze the characteristics and determine which of these anomalies will cause an event. Is this in agreement with your findings, or have you found characteristics that pose a greater risk? Thank you.

submitted by Kelly from Greenleaf, Wisconsin on 2/20/2014

Answer:

by Texas Heart Institute cardiologist, Roberto Lufschanowski, MD  

Roberto Lufschanowski, MDDear Kelly: We have a protocol. We do intracoronary ultrasound, both baseline and during Dobutamine infusion. It is a simple technique that allows more precise evaluation of the degree of compression. This is not a rare anomaly but difficult to make precise and sometimes arbitrary recommendations. 

See also on this site: 

Has your question or a similar one already been answered?
Search all the Heart Doctor questions and answers.

To search for a doctor or access St. Luke's physician referral service, use the "Find a Doctor" link at the top of this page.


Updated February 2014
Top  
Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
Like us on Facebook Follow us on Twitter Subscribe to us on YouTube Find Us on Flicikr Follow Us on Pinterest Add us on Google+

Please contact our Webmaster with questions or comments.
Terms of Use and Privacy Policy
© Copyright 1996-2014 Texas Heart Institute.
All rights reserved.
This website is accredited by Health On the Net Foundation. Click to verify. U.S. NEWS America's Best Hospitals 2013-14