Imaging characteristics of anomalous left coronary artery from the pulmonary artery
Meng-Luen Lee1, Ing-Sh Chiu, Shyh-Jye Chen
1Department of Pediatrics, the Division of Pediatric Cardiology, and the Pediatric Intensive Care Unit, Changhua Christian Hospital, Changhua, Taiwan.
Insights
An infant with anomalous left coronary artery from the pulmonary artery showed improved heart function after surgery. This rare congenital heart defect requires prompt diagnosis and intervention for survival.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect.
- ALCAPA can lead to severe left ventricular dysfunction and myocardial infarction in infants.
- Early diagnosis and surgical correction are crucial for improving outcomes.
Observation:
- A 6 1/2-month-old male infant presented with tachycardia, feeding difficulties, failure to thrive, and myocardial infarction.
- Diagnostic imaging included electrocardiography, echocardiography, angiography, and electron-beam computed tomography.
- These modalities revealed the anomalous origin of the left coronary artery from the pulmonary artery.
Findings:
- Surgical reimplantation of the left coronary artery to the ascending aorta was performed.
- Post-operative echocardiography at 7 months demonstrated improved left ventricular function.
- Electrocardiography showed regression of pathologic Q waves, indicating myocardial recovery.
Implications:
- Successful surgical correction of ALCAPA can lead to significant clinical improvement and recovery of cardiac function.
- Multimodality imaging plays a vital role in diagnosing this rare condition.
- Prompt intervention in ALCAPA is associated with favorable long-term outcomes in pediatric patients.
Summary:
The authors report the imaging characteristics of the anomalous origin of the left coronary artery from the pulmonary artery in a 6 1/2-month-old male infant using electrocardiography, echocardiography, angiography, and electron-beam computed tomography. The patient presented with tachycardia, prolonged and interrupted feeding, failure to thrive, and myocardial infarction, and after diagnosis of the anomalous origin of the left coronary artery, survived the reimplantation of the left coronary artery directly to the ascending aorta. When reviewed 7 months after surgery, echocardiography showed improved left ventricular function and surface electrocardiography showed regression of pathologic Q waves in leads I, V 4, V 5, and V 6.
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