Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Detected by Echocardiography in an Asymptomatic Young Athlete (original) (raw)
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Cardiovascular Journal, 1970
Anomalous origin of the left coronary artery from the pulmonary artery is a serious congenital cardiac defect associated with high mortality rates in infancy. It is undoubtedly a rare defect but its diagnosis during life is possible in most cases, and successful surgery appears within reach. The object of this paper is to report our experience with a fourteen years old girl with this rare anomaly. The presenting symptoms of our patient during infancy were not that are considered classic for this anomaly. Though the child had excessive sweating and symptoms of heart failure during infancy. The girl was suspected to have ALCAPA clinically and echocardiographically finally selective right coronary arteriography established the diagnosis. Keywords: Congenital heart disease; ALCAPA. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9397 Cardiovasc. J. 2011; 4(1): 92-95
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a very rare often fatal congenital coronary artery anomaly that occurs in approximately only 1 of 300,000 live births. Many cardiologists and pathologists may be unaware that cardiac ischemia and sudden death can also occur due to ALCAPA in adults in whom it is even rarer and thus may be missed at autopsy. The adult form may range clinically from asymptomatic to sudden cardiac death. We present four cases of adult ALCAPA that illustrate the variable presentations and survival. Two had died at rest and were previously asymptomatic. The other two died during exertion with history of recent chest pains in one and previous myocardial infarction in childhood in the other. This last case remained asymptomatic until death. These four cases highlight that surgery should be undertaken in all cases, even in those who are asymptomatic as newer imaging makes the diagnosis in life more frequent. Age is not important as cases vary widely in age from 22 to 68 in our small group. Furthermore, the most common site of left coronary artery origin is the left pulmonary sinus but our autopsy study shows that the origin can be variable extending above the pulmonary valve sinus to the main pulmonary artery.
Adult type anomalous origin of the left coronary artery from the pulmonary artery
The Turkish journal of pediatrics
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a clinical entity characterized by myocardial necrosis which becomes symptomatic shortly after birth; survival beyond infancy is uncommon because of severe left heart failure. To our knowledge, it is rare for an ALCAPA patient to survive to adulthood. Here we present a case of a 17-year-old girl with ALCAPA who was referred to our hospital because of palpitation and dyspnea.
2015
Congenital heart disease, pulmonary artery abnormalities, ALCAPA, myocardial ischemia, coronary reimplantation. Palabras clave: Cardiopatias congenitas, ABSTRACT Objective: To describe conduct, evolution and surgical treatment of ALCAPA in adult patients. Material and methods: Series of fi ve cases, > eighteen years old. Clini- cal data (including surgery and follow-up), and echocar- diographic/hemodynamic studies were reviewed. Results: The series comprised four women (80%) and a man (20%), with a mean age of 38.2 (range 18-65) years. Myocardial ischemia was found in three patients (60%), detection of a cardiac murmur in one patient (20%) and aborted sudden death in one patient (20%). Physical examination was normal in every case. Two patients (40%) presented grade II cardiomegaly and venocapillary pulmonary hyperten- sion. In three cases, subendocardial ischemia was found on the EKG without necrosis evidence. Echocardiogram was performed in every patient. On the short axis wind...
Anomalous Left Coronary Artery from the Pulmonary Artery: How to Diagnose and Treat
Journal of Personalized Medicine
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare coronary anomaly that can present in childhood or adulthood with a multitude of symptoms depending on the age of presentation. It should be suspected in infants presenting with heart failure in the setting of left ventricular systolic dysfunction and associated mitral regurgitation from papillary muscle ischemia. Adults with ALCAPA may present with cardiac ischemic symptoms. Prompt diagnosis with echocardiography and cross-sectional chest imaging is important to guide surgical intervention and improve the patients’ survival and prognosis. The goal of surgery is to establish a dual-coronary system with mid-term results revealing progressive recovery of left ventricular function and improvement in mitral regurgitation. Patients with ALCAPA should maintain life-long follow-up with a cardiologist with congenital heart disease expertise for surveillance of post-operative complications.
2016
Background Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiovascular defect that occurs in approximately 1/300 000 live births or 0.5% of children with congenital heart disease. There are two types of ALCAPA syndrome: the infant type and the adult type. The most infants experience myocardial infarction and congestive heart failure, and approximately 90% die within the first year of life; also, without early surgical intervention they have a dismal prognosis. Materials and Methods We report 3- year experiences from January 2013 to January 2016 of Imam Reza Hospital center (a tertiary referral hospital North East of Iran) that consist of all patients with ALCAPA syndrome. Results The Takeuchi procedure, were successfully performed in five children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). There was no death and significant mitral regurgitation postoperative (n=0) in this short study. All of patient...
2020
Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) syndrome is a potentially lethal and rare congenital cardiac anomaly (for approximately 1 in 300,000 live births). ALCAPA syndrome mostly presents in the first few months of life. Left untreated, the mortality rate in the first year of life is 90% secondary to myocardial ischemia or infarction and mitral valve insufficiency leading to congestive heart failure. When pulmonary arterial pressure decreases, it results in reversal of flow so that LCA drains from the right coronary artery through collateral vessels into the pulmonary artery. This phenomenon causes ischemia or eventually infarction of the anterolateral left ventricular wall. Sudden death may occur because of inadequate collateral circulation between LCA and the right coronary artery and/or development of arrhythmia. ALCAPA can be found both in infants and in older individuals, with the absence or presence of strong collateral circulation ...
Avicenna Journal of Medicine, 2019
Congenital anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is associated with early infant mortality and adult sudden death. The use of advanced cardiac imaging has resulted in an increase in the number of diagnosed ALCAPA cases, especially in the adult population, sometimes even asymptomatic. The extent of collateral circulation that develops between the right coronary artery (RCA) and left coronary artery (LCA) determines the outcomes. We present a case of hitherto undiagnosed case of ALCAPA, with first presentation as acute coronary syndrome (ACS) in young male.
IP innovative publication pvt. ltd, 2019
ALCAPA is a rare congenital anomaly of the coronary system of the heart in which the left coronary artery, which normally arises from the aorta, takes its origin from the pulmonary artery. It is a cause of myocardial ischemia in infancy and causes up to 90% mortality in the first year of life if left untreated. Diagnosis has become easy with the advent of 2D echocardiography. Surgery is the mainstay of therapy with good short and long term results.
Journal of Cardiovascular and Thoracic Research
ALCAPA is a rare congenital heart disease. Presentation varies from asymptomatic to progressive heart failure and death. Surgical repair is indicated in all patients with a goal of restoring two coronary systems. Data was analysed in regard to presenting features, echocardiographic findings, various surgical approaches used and immediate, early and midterm post-operative results. Most common presentation was growth failure and seen in 6 patients. One patient was taken for elective PDA ligation and diagnosis of ALCAPA was made on table after PDA ligation as patient crashed subsequently. Aortocoronary button transfer was most commonly used surgical technique while 2 patients needed interposition grafting. LV function improved in 5 out of 8 patients with regression of MR. A median improvement of 5+-2% was observed in ejection fraction of 5 patients. Early surgery with aortocoronary transfer offers good results with gradual improvement in LV dysfunction and mitral regurgitation.