Hypoplastic coronary artery disease and hypertension in a child: a case report

Hypoplastic coronary artery disease (HCAD) is an extremely rare disease associated with a risk of sudden cardiac death. It is rarely recognized in a live paediatric patient.

We report a case of HCAD in a patient who first presented with vomiting and poor feeding, suggestive of acute heart failure due to cardiomyopathy or acute myocarditis in infancy. Hypertension and signs of ischaemia became evident on electrocardiography and scintigraphy after his cardiac function fully recovered, and he was diagnosed with HCAD by angiography performed at the age of 8 years. He has remained under close observation with anti-hypertensives, aspirin, and exercise restriction.

Although HCAD is a rare disease, it may not only cause ischaemia but may also result in heart failure and sudden cardiac death. It should be considered in any paediatric patient with heart failure. Mid-term follow-up visits might be necessary to detect signs of ischaemia in paediatric patients presenting with features of heart failure.