A rare congenital cardiovascular abnormality presenting as respiratory distress in an infant

Area of Science:

• Pediatric Cardiology
• Congenital Cardiovascular Anomalies

Background:

• Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiovascular anomaly.
• It typically presents in early infancy with congestive cardiac failure, often exacerbated by respiratory infections.

Observation:

• A case report of an eight-week-old infant boy presenting with cough, dyspnea, tachycardia, and respiratory distress.
• Initial management for bronchiolitis was complicated by recurrent desaturation events requiring intubation and mechanical ventilation.
• Chest X-ray showed cardiomegaly; echocardiography confirmed ALCAPA leading to myocardial ischemia.

Findings:

• Echocardiography definitively diagnosed anomalous left coronary artery from the pulmonary artery (ALCAPA).
• The condition resulted in significant myocardial ischemia in the infant.
• Surgical revascularization was performed as the definitive treatment.

Implications:

• This case highlights the importance of considering ALCAPA in infants with unexplained cardiorespiratory symptoms.
• Prompt diagnosis and surgical intervention are crucial for successful outcomes in ALCAPA.
• Early recognition and management can prevent severe complications and improve survival rates for this rare anomaly.