Unusual cause of left ventricular dysfunction in a child
Maria Emanuel Amaral1, Pedro Epifânio1, Natália Noronha1
1Serviço de Cardiologia Pediátrica - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Revista Portuguesa De Cardiologia
|May 26, 2018
Summary
An unusual congenital heart defect, Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA), was diagnosed in an 8-year-old. Successful surgical repair created a dual coronary artery system, highlighting diagnostic challenges.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiovascular Surgery
Background:
- Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) is a rare congenital heart defect.
- It often leads to myocardial ischemia in children and high mortality within the first year if undiagnosed.
- Early diagnosis and intervention are critical for survival.
Observation:
- An 8-year-old asymptomatic child presented with left ventricular dilatation and dysfunction.
- Echocardiogram revealed turbulent flows at the interventricular septum, suggesting ALCAPA.
- Previous diagnosis at 3 months was heart failure with dilated cardiomyopathy.
Findings:
- Computerized angiotomography and cardiac catheterization confirmed ALCAPA.
- The patient underwent successful surgical reimplantation of the left coronary artery to the aorta.
- This created a dual coronary perfusion system, restoring normal blood flow.
Implications:
- This case highlights an unusual long-term survival of undiagnosed ALCAPA.
- It underscores the importance of high clinical suspicion and multimodality imaging in diagnosing rare pediatric cardiac conditions.
- Successful surgical correction offers a favorable prognosis for ALCAPA patients.
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