Coronary artery fistula is an abnormal connection between the coronary artery and the heart or other blood vessels. Coronary arteries carry oxygen-rich blood to the heart tissue. A small fistula will not affect this blood flow, but larger ones may cause problems.
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This is often caused by a congenital defect. This means that a baby is born with it. It is not known exactly why this happens.
Some fistulas can also happen after birth due to infection, injury, or heart surgery.
Risk factors for this problem are not known.
Most children with mild fistulas do not have symptoms. Rarely, those who do have symptoms may have:
- Chest pain
- Fast heartbeat
The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the heart. This problem may be suspected if the doctor hears a heart murmur.
Images may be taken of your child's body. This can be done with:
Your child's heart function may be tested. This can be done with:
Surgery will be done to correct the defect. Choices are:
- Coil embolization to close off the abnormal vessel by placing a coil through blood vessels in the arms or legs and passing it to the heart
- Open heart surgery to close the defect with stitches
Lifelong heart monitoring will be needed after treatment.
There are no known guidelines to prevent this heart problem.
American Heart Association
Family Doctor—American Family Physician
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Coronary artery fistula. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1748/mainpageS1748P1.html. Accessed December 27, 2017.
Coronary artery fistula. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=coronaryfistula1. Updated January 24, 2017. Accessed December 27, 2017.
Lin C-T, Lin T-K. The current status of coronary artery fistula. J Intern Med Taiwan. 2009;20:484-489.
Last reviewed December 2020 by EBSCO Medical Review Board Kari Kassir, MD Last Updated: 3/10/2021