An anomalous coronary artery wasn’t formed correctly in the womb. This rare problem means your coronary artery is in the wrong spot or it started in the wrong spot. This can cause problems with how your blood circulates through your heart. When your heart muscle doesn’t get the oxygen it needs, tissues can die.
An anomalous coronary artery wasn’t formed correctly before birth. In many cases, the coronary artery is in the wrong place or is coming from the wrong place. This problem can affect:
The problem with anomalous coronary arteries is that they aren’t where they’re supposed to be. They may start in:
Types of coronary artery anomalies include:
A common coronary artery anomaly is an artery coming out of the wrong aortic sinus of Valsalva. Normally, the right coronary artery comes out of the right aortic sinus of Valsalva. Similarly, the left coronary artery comes out of the left aortic sinus of Valsalva.
A coronary artery that starts from the pulmonary artery instead of the aorta is another type of anomaly. This can affect the left or right coronary artery or (rarely) both. A rare form involves an accessory artery. In some cases, the normal coronary artery can make up for what the abnormal coronary artery can’t do. This is why some people don’t have symptoms until they become adults.
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Up to 1% of the population has an anomalous coronary artery. Most cases are not dangerous.
When one of your coronary arteries is in the wrong place, it disrupts the normal way blood flows through your heart. This can keep oxygen-rich blood from getting to your heart muscle.
Anomalous coronary artery symptoms may differ based on the type of anomaly. Many children don’t have symptoms of anomalous aortic origin of a coronary artery (AAOCA) from opposite sinus of Valsalva. Sudden cardiac arrest or sudden cardiac death during exertion may be the first sign of it.
Anomalous aortic origin of a coronary artery (AAOCA) symptoms include:
Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) symptoms may show up at birth or between ages 40 to 60. Symptoms may include:
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) symptoms often show up in a baby’s first year. They include:
Children or adults with ALCAPA can have:
An anomalous coronary artery is a congenital problem, which means you were born with it. This rare heart problem happens to a baby during its first month or so in the womb when the coronary arteries form.
Diagnosis & Tests
Making an anomalous coronary artery diagnosis can be difficult because someone with the condition can have a normal physical exam. Also, some people don’t have symptoms.
Tests for anomalous coronary artery include:
Providers recommend surgery for certain people (with or without symptoms) with anomalous origin of the left coronary artery, but only for some of those who have anomalous origin of the right coronary artery with symptoms. Most adults with anomalous origin of the right coronary artery don’t need surgery.
If surgery isn’t a good option, your provider may recommend limiting your exercise and taking blood pressure medicines like diuretics or beta blockers. You won’t need to limit your exercise if your anomaly isn’t dangerous.
Many people without symptoms, especially young and healthy people, choose to have surgery to prevent possible problems with their coronary arteries.
Surgeries for anomalous coronary artery include:
Complications/side effects of the treatment
Surgery has a small risk of death. Complications include bleeding and blood clots.
Unfortunately, you can’t prevent anomalous coronary artery because it’s a condition you have when you’re born.
If you’ve had surgery to correct the problem, you can go back to sports activities three months after surgery. You can have a normal life, but will need to get regular medical checkups.
How long does anomalous coronary artery last?
Since anomalous coronary artery is a problem you’re born with, it will always be there unless you have surgery.
Outlook for anomalous coronary artery
If your baby has ALCAPA and doesn’t receive treatment, there’s a 90% chance it will be fatal. In a small number of cases, people grow to be adults with no symptoms or have symptoms as adults. The outlook is good if your provider treats ALCAPA before problems happen. However, there isn’t much information about long-term benefits of treating anomalous coronary arteries.
For AAOCA, surgical unroofing gets rid of symptoms and protects you from sudden death.
If you’re waiting to have surgery or if surgery isn’t a good option for you, your provider may ask you to limit your exercise. If you’re considered low risk, you may not need surgery and can exercise as much as you want.
Contact your provider when your baby:
For adults, see the list of symptoms.
You should go to the ER if you’re having chest pain.
A note from Cleveland Clinic
While most people with an anomalous coronary artery aren’t in danger, the problem can be very dangerous for some. Sometimes people don’t have symptoms until they have a sudden cardiac arrest. Fortunately, several surgical options can protect you from sudden death and help you have a normal life. Be sure to keep taking any medicines your provider ordered and get regular checkups.
Last reviewed by a Cleveland Clinic medical professional on 09/17/2021.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy