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 fistulas may cause problems.
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This condition is typically a congenital defect. This means that a baby is born with it. It is not known exactly why the fistula develops.
Some fistulas can also occur after birth due to infection, injury, or heart surgery.
The risk factors for coronary artery fistula are unclear.
Children with this condition usually do not have any symptoms.
A large fistula may cause chest pain, an irregular heart beat, or an abnormal pulse, but this is rare. If your child has any of these symptoms, get emergency medical care right away. In severe cases, this condition can lead to a heart attack, heart failure, or a ruptured fistula.
You will be asked about your child’s symptoms and medical history. A physical exam will be done. A coronary artery fistula may be suspected if a heart murmur is heard during a physical exam.
Images may be taken of your child's bodily structures. This can be done with:
Your child's heart function may be tested. This can be done with:
Talk with the doctor about the best treatment plan for your child. Options include:
Surgeries that may be done to treat this condition include:
- Coil embolization —A special coil is passed through blood vessels in the arms or legs to the heart. The coil can close off the abnormal vessel.
- Open heart surgery—to close the defect with stitches.
Your child will have regular exams by a heart doctor. This is done to prevent major complications.
Preventing heart defects may not always be possible. However, getting regular prenatal care is always important.
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 November 2018 by EBSCO Medical Review Board Kari Kassir, MD Last Updated: 12/20/2014