eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Cardiology

Coronary Artery Anomalies: Follow-up

Author: Andrew N Pelech, MD, Professor, Department of Pediatrics, Medical College of Wisconsin; Director of Cardiac Catheterization Laboratory, Cardiology Research Focus and Cardiology Database, Director of Herma Heart Center Clinical Research, Children's Hospital of Wisconsin; Chairman of Wisconsin Pediatric Cardiac Registry
Contributor Information and Disclosures

Updated: Jun 1, 2009

Follow-up

Transfer

  • Transfer patients to a facility with specialists experienced in the techniques of selective coronary arteriography and intervention, with specialists experienced in nuclear medicine, with radiographers knowledgeable in quantification of myocardial injury and recovery potential, and with both pediatric and adult cardiovascular surgeons to facilitate optimal surgical repair.

Patient Education

  • Advise cautious reintegration into physical education and sports for those patients who have sustained a cardiac injury.
  • For excellent patient education resources, visit eMedicine's Heart Center. Also, see eMedicine's patient education article Tetralogy of Fallot.

Miscellaneous

Medicolegal Pitfalls

  • Discounting or failing to recognize a chest wall or respiratory etiology for symptoms of chest pain or precordial discomfort from coronary insufficiency is perhaps the greatest potential problem. Avoidance of this pitfall requires a vigilant description of the character of the chest pain, the circumstances under which symptoms arise, associated symptoms, the duration of discomfort, and the precipitating factors. Discomfort caused by coronary artery anomalies is typical of anginal pain.
  • Another medicolegal pitfall is a failure to recognize, most importantly, that exertion precipitates cardiac causes of chest pain and that the quality of pain is described as a pressure or squeezing sensation but generally not as a sharp pain.
  • Failing to recognize that any activity-related syncopal event is most suggestive of a coronary or dysrhythmic etiology and requires comprehensive evaluation and investigation is another problem.
 


More on Coronary Artery Anomalies

Overview: Coronary Artery Anomalies
Differential Diagnoses & Workup: Coronary Artery Anomalies
Treatment & Medication: Coronary Artery Anomalies
Follow-up: Coronary Artery Anomalies
Multimedia: Coronary Artery Anomalies
References
Further Reading
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References

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Keywords

coronary artery malformations, abnormalities of the coronary vasculature, coronary artery anomalies, right coronary artery, RCA, left coronary artery, LCA, left anterior descending artery, circumflex artery, LAD, Cx, coronary ostia, coronary artery disease, CAD, myocardial ischemia, sudden death, myocardial dysfunction, angina, syncope, dysrhythmia, congestive heart failure, CHF, failure to thrive, ostial stenosis, coronary ischemia, coronary artery fistula, endocarditis, elfin facies, infantile hypercalcemia, hypoplastic teeth, transposition of the great arteries, tetralogy of Fallot, pulmonary atresia, left ventricular outflow tract obstruction, mitral valve insufficiency, treatment, diagnosis

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Contributor Information and Disclosures

Author

Andrew N Pelech, MD, Professor, Department of Pediatrics, Medical College of Wisconsin; Director of Cardiac Catheterization Laboratory, Cardiology Research Focus and Cardiology Database, Director of Herma Heart Center Clinical Research, Children's Hospital of Wisconsin; Chairman of Wisconsin Pediatric Cardiac Registry
Disclosure: Nothing to disclose.

Medical Editor

Juan Carlos Alejos, MD, Clinical Professor, Department of Pediatrics, Division of Cardiology, University of California at Los Angeles
Juan Carlos Alejos, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Medical Association, and International Society for Heart and Lung Transplantation
Disclosure: Actelion Honoraria Speaking and teaching

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Julian M Stewart, MD, PhD, Associate Chairman of Pediatrics, Director, Center for Hypotension, Westchester Medical Center; Professor of Pediatrics and Physiology, New York Medical College
Julian M Stewart, MD, PhD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

CME Editor

Gilbert Z Herzberg, MD, Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College; Consulting Staff, Department of Pediatrics, Sound Shore Medical Center
Gilbert Z Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Chief Editor

Steven R Neish, MD, SM, Director of Pediatric Cardiology Fellowship Program, Associate Professor, Department of Pediatrics, Baylor College of Medicine
Steven R Neish, MD, SM is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, and American Heart Association
Disclosure: Nothing to disclose.

 
 
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