Title : Coronary Artery Abnormalities in Children
Abstract:
Coronary artery abnormalities whether congenital or acquired are an important cause of morbidity and mortality in Children. The current talk will focus on Congenital coronary abnormalities as well acquired coronary disease i.e., Kawasaki disease in children.
Coronary Artery Anomalies (CAA) can result in Sudden Cardiac Death (SCD), and it is the second most common abnormality associated with SCD in young athletes. Affected patients can present with exertional chest pain, exertional syncope and sometimes the first presentation is one of SCD. While the initial screen with an echocardiogram with dedicated coronary artery imaging can delineate the anomalous origin of a coronary artery (AAOCA) from the wrong aortic sinus, many of the high-risk features needs advanced imaging like Cardiac CT. Cardiac CT can delineate the abnormal origin of the coronary arteries accurately, characterize the ostia, the length of intra mural course etc. In addition, stress imaging with dobutamine (Stress Cardiac MR) can determine areas of perfusion abnormalities in the affected segment. We also share our hospital experience and outcomes for over a decade with coronary artery unroofing surgical procedure for AAOCA.
Kawasaki disease resulting in Coronary Artery Aneurysms are an important cause of morbidity in children. Although rare giant CAA can cause myocardial ischemia, coronary thrombosis and sudden cardiac death. There is a highly effective form of treatment with Intravenous immunoglobulin which has to be given within 10 days of febrile illness and this decreases the incidence of coronary artery aneurysms to less than 5 percent.
Aims of the talk:
- Recognize that CAA are an important cause of morbidity and mortality in Children
- Understand the various clinical manifestations of CAA in children
- Evaluation of CAA using noninvasive imaging including CT and Cardiac MR
- Evaluation and Management of Coronary Artery Aneurysms secondary to Kawasaki Disease
