Sometimes children are born with an abnormal placement of the arteries that supply the heart with blood (the coronary arteries). Additionally, abnormal branches from the coronary arteries, or fistulas, may be present.
Many children with this type of congenital (present at birth) heart disease will not have any symptoms. Some will have symptoms like chest pain, arrhythmias, or passing out (syncope) with exercise. In rare circumstances, the abnormality can result in sudden death.Infants with a condition called anomalous left coronary artery arising from the pulmonary artery (ALCAPA) may become sick with difficulty feeding and increased work of breathing within the first few months of life due to progressive deterioration of heart function. This requires a surgery to remove the coronary artery from the pulmonary artery (the artery leading from the heart to the lung) and to reattach the vessel back to the aorta (the main blood vessel leading from the heart to the body). Because there is usually some damage to the heart caused by the reduced blood flow to the heart, the squeezing function of the heart may be reduced. The function of some of the valves letting blood into the heart may be affected, resulting in significant leakage of the valve. Even after reattaching the anomalous coronary artery back to the heart, the squeezing function of the heart and valve function may not recover, resulting in a cardiomyopathy.