Clinical analysis of right coronary artery anomalies in 8 children / 中华实用儿科临床杂志

ABSTRACT

Objective To observe the clinical characteristics and improve the diagnosis and treatment of right coronary artery anomalies in children.Methods The clinical characteristics,laboratory examination,treatment and prognosis were retrospectively analyzed in children with right coronary artery anomalies (complex cardiac anomalies was excluded),who were admitted into Beijing Children's Hospital Affiliated to Capital Medical University from January 2009 to December 2014.Results A total of 8 medical records of children with right coronary artery anomalies,among whom 5 cases were male and 3 cases were female,with a mean age of (7.06 ± 1.37) years old.In these 8 patients,there were 5 patients with right coronary artery originating from left coronary sinus,1 patient with right coronary artery originating from left wall of aorta,1 patient with single left coronary artery type Lipton L Ⅱ,and 1 patient with right coronary artery absence.The main symptoms included chest distress,chest pain and palpitation in elder children,but in infants,the primary symptom was poor feeding.One case of these patients represented syncope.Electrocardiogram of these patients showed ST-T wave changes,sinoatrial block,and sinus arrest.Ultrasonic cardiogram failed to discover the coronary artery anomalies.Four cases showed enlarged left ventricular end-diastolic diameter,and 1 case showed slight decrease of left ventricular ejection function.All 8 patients were given myocardial tonic with limitation in doing exercise,and clinical follow-up studies were conducted for 6 months.Four patients with enlarged left ventricular were treated with Captopril,and 3 patients of them recovered after 3 to 6 months.Two patients with sinus node malfunction were treated with permanent pacemaker implantation in other hospitals.Conclusions Right coronary artery anomaly in children is rare.Patients with cardiac ischemia and sinus node malfunction should be aware of right coronary malformation.64-section multidetector computerized tomography angiography can diagnose right coronary artery anomalies.To patients with right coronary artery anomalies,vigorous exercises should be avoided to decrease adverse cardiac events.