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Intractable atrial flutter presented with severe bradycardia in an infant.

to be accelerated in these patients (5). Although the etiology of this accelerated atherosclerotic heart disease is unknown, a number of factors probably play a role. Hypertension is a known risk factor for the development of coronary artery disease (6). There must be factors other than hypertension, because even considering the higher incidence of hypertension, the incidence of coronary artery disease is much higher than one would expect. Some individuals with coarctation of the aorta are known to have altered structure and function of both the coronary and other systemic arteries. Chen et al. (7) described severe atherosclerosis and calcification in internal mammary arteries of two patients with previous coarctation repair who required coronary artery bypass surgery (7). In clinical practice, the development of dissection in a patient with coronary artery disease is common immediately after balloon angioplasty because of intimal tearing. No spontaneous coronary dissection in a patient with coarctation of aorta was reported in literature.