Anomalous origin of the left coronary artery from the pulmonary artery presenting as dilated cardiomyopathy: a case report (original) (raw)
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Journal of Health, Medicine and Nursing, 2018
Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital heart anomaly that account for up to 0.5% of all congenital heart disease. Usually, infants' patients may present with failure to thrive, feeding difficulties, sweating, irritability or sudden cardiac death. However, they may be asymptomatic. This syndrome has a high mortality rate if left untreated during infancy period. Echocardiography and electrocardiography are helpful in detecting and establishing the diagnosis of Anomalous origin of the left coronary artery from the pulmonary artery for infants. Surgical repair to restore normal anatomical position of coronary system is the definitive intervention. Early detection and surgical intervention has significant positive impact on survival rate. This paper presents a case of a four months old girl, who presented with heart failure, dilated cardiomyopathy and mitral regurgitation and thereafter was diagnosed with Anomalous origin of the le...
Archivos argentinos de pediatria, 2018
Isolated anomalous origin of the right coronary artery from the main pulmonary artery is a rare congenital anomaly, and few cases have been reported in the pediatric age group. Here in, we report an asymptomatic case of a 2-month-old male infant who has been diagnosed as anomalous origin of the right coronary artery from the main pulmonary artery during the evaluation for cardiac abnormalities. For a suspicion on echocardiography, cardiac catheterization and coronary angiography performed to verify the diagnosis of anomalous origin of the right coronary artery from the main pulmonary artery. The patient underwent surgery and did well after two months follow up. Early diagnosis may prevent patients from cardiovascular complications.
Isolated Anomalous Origin of Right Coronary Artery from the Main Pulmonary Artery
Journal of Cardiac Surgery, 2005
The anomalous origin of the right coronary artery (ARCA) from the main pulmonary artery (MPA) is a rare congenital cardiac malformation and usually associated with other cardiac anomalies. Most patients with isolated ARCA from MPA remain asymptomatic, but they may develop myocardial ischemia and even sudden death. We reported an asymptomatic 7-year-old boy referred for evaluation of a heart murmur. Isolation of ARCA from MPA was diagnosed by echocardiography and then confirmed by cardiac catheterization and angiography. The right coronary artery was re-implanted into the ascending aorta. A preoperative thallium-201 myocardial perfusion showed a myocardial ischemia pattern in the anterolateral septal area after a dipyridamole stress test; the ischemia was completely resolved after surgery.
Anomalous origin of the left coronary artery from the pulmonary artery
The American Journal of Cardiology, 1965
ABSTRACT Anomalous origin of the left coronary artery from the pulmonary artery (ALCA-PA) is a rare form of congenital heart disease. In this report, three cases with this anomaly are described; two patients presented in infancy with heart failure from myocardial ischemia and infarction, while the third was asymptomatic and ALCA-PA was diagnosed during evaluation of a residual murmur after surgery for associated cardiac defects (ventricular septal defect and patent arterial duct). All three cases underwent aorto-pulmonary tunnel repair (Tukeuchi procedure), and to our knowledge two of them are the first infantile cases reported in Turkey.
2021
Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac anomaly. The majority of patients die within the first year of life if left untreated. However, a few patients can be asymptomatic and survive into adulthood due to well-developed collateral between the left coronary artery and the dilated right coronary artery. Case presentation: We reported a case of a male who has been having nonspecific symptoms since infancy which were misdiagnosed as symptoms of heart failure. At the age of 18 years old, he presented with a sudden death, and his autopsy revealed ALCAPA syndrome with a dilated right coronary artery. Histopathological studies demonstrated myxoid degeneration of media of the proximal left coronary artery (LCA), right coronary artery (RCA) collaterals, the proximal RCA and the leaflet of mitral valve. In addition, interstitial fibrosis of the papillary muscle of the the mitral valve and leaflet of mitral valve, distal LCA, and in the left ventricle endocardium was observed. Conclusions: Aperiodic diagnosis and follow-up for the cardiovascular system is recommended for similar cases. In addition to the current recommended approaches for ALCAPA treatment, further studies emerge the need for determining reliable, noninvasive diagnostic biomarkers for early screening this congenial anomaly of the heart during infancy to avoid a tragic ending.
Anomalous left coronary artery arising from the pulmonary artery (adult type)
American Heart Journal, 1950
, 21 consecutive infants aged less than six months (mean (SD) 2-6 (1 2)) were admitted with anomalous origin of the left coronary artery from the pulmonary artery. In the first 12 patients, who were seen up to 1982, operation was performed after the age of one year (mean (SD) 29 (29) months) (group 1). The next nine infants, seen from 1983 to 1987, had their operations within a few weeks of the onset of symptoms (mean (SD) age 4-8 (1 4) months) (group 2). In group 2 the left coronary artery was relocated into the aorta, whereas in group 1 there was additional resection of the left ventricular wall or mitral valvoplasty or both. At presentation there were no differences in age, clinical condition, heart enlargement, and echocardiographic left ventricular dysfunction between groups 1 and 2. Seven of the 12 patients in group 1 died, five while they were awaiting operation (three died suddenly at home) and two at operation. The five survivors are doing well 6-4 (3-1) years after operation with normal left ventricular function which improved slowly over several months after operation. Two of the nine patients in group 2 died; both deaths occurred at or soon after operation. The seven survivors are doing well 1 8 (0 9) years after operation. In three, left ventricular function recovered within three weeks; and there was even partial or total regression of the Q waves in the supposedly necrotic areas. In the remaining four the pattern of improvement in left ventricular function resembled that in group 1. Operation should be undertaken early in infants with anomalous left coronary artery arising from the pulmonary artery because the procedure is relatively safe, prevents a high natural mortality, and offers a better chance of a faster recovery of left ventricular function.