Question:

Where can I get information regarding anomalous origin of the right coronary artery?

While on the operating table for a minor ear surgery, my 9 year old son showed a Right Bundle Branch Block. After a 24 Holter, EKG, MRI and stress MIBI test, it has been determined he has anomalous origin of the right coronary artery from the left sinus. He was asymptomatic, but we have been told he has an increased risk of sudden death. He is quite athletic (involved in hockey, baseball, soccer, etc.) We have a great children’s hospital in our city, but the cardiologists there have never seen a case of this and have sent our test results out to experts around North America. As the replies slowly roll in, we have been told to cut out all competitive sports (as per the Bethesda suggestions), but not to limit recreational activity. What level of activity is considered “competitive”? What sports are considered okay to participate in? Are their other forms of treatment/management that may allow him to remain activity or correct this defect? Are there any long-term studies of this condition?

Submitted by Kara from Cole Harbour, Nova Scotia, Canada on 02/05/2014

Dear Kara: Your son’s condition (anomalous origin of right coronary artery from left sinus) is not rare and the majority of the patients do not have problems. Unfortunately, in order to make specific recommendations, we need more information. A CAT scan coronary angio is needed but that is beyond the scope of this “Ask a THI Heart Doctor” format. At the Texas Heart Institute, we have a Center for Coronary Anomalies. Good luck,