What Is a Congenital Coronary Artery Abnormality?
People who have this condition are born with an abnormal coronary artery. Most commonly, the left coronary artery originates from the area where the right coronary artery originates, or vice-versa. The abnormal origin means that the artery forms a sharp angle that can "kink" during strenuous exercise, when there is more stress on the vascular system. The kinking can cut off the flow of blood to the heart muscle, which then can produce fatal cardiac arrhythmias and sudden death.Some people with congenital coronary artery abnormalities will experience symptoms during exercise, such as chest pain or shortness of breath, or sometimes loss of consciousness (syncope). However, as unfortunate as it is, sudden death is most commonly the first symptom.
Most of the time the physical examination is normal, and unless the athlete describes symptoms during exercise, there is no reason for the doctor to suspect the condition. If the condition is suspected, it can sometimes be diagnosed with a cardiac MRI study or a cardiac CT scan, although a cardiac catheterization is still considered the gold standard for making the diagnosis.
If a congenital coronary artery abnormality is diagnosed, it can usually be treated effectively with cardiac surgery, to re-route or bypass the affected artery.
What Are the General Exercise Recommendations For Young Athletes With Coronary Artery Abnormalities?
According to the 2005 36th Bethesda Conference on Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities, athletes who have congenital coronary artery abnormalities should refrain from all competitive sports. After surgical correction of their condition, they may participate in competitive sports.Sources:
Graham, TP Jr, Driscoll, DJ, Gersony, WM, et al. Task Force 2: congenital heart disease. J Am Coll Cardiol 2005; 45:1326.
