Asymptomatic ALCAPA with Preserved Myocardial Function in a 3-Year-Old Child

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 anomaly with typically severe infantile presentation.
• Untreated ALCAPA can lead to left ventricular ischemia, cardiogenic shock, and high mortality rates.
• The typical presentation contrasts with atypical, less severe clinical courses observed in some cases.

Purpose of the Study:

• To report a rare case of ALCAPA in a 3-year-old girl.
• To describe the specific cardiovascular findings, including collateral circulation and left ventricular function.
• To discuss the implications of these findings on the clinical course and management of ALCAPA.

Main Methods:

• Case report of a 3-year-old female patient.
• Diagnostic evaluation including echocardiography and potentially other imaging modalities (details not provided in abstract).
• Assessment of coronary artery anomalies, collateral pathways, and ventricular function.

Main Results:

• Diagnosis of anomalous left coronary artery from the pulmonary artery (ALCAPA) in a 3-year-old girl.
• Identification of extensive right-to-left collateral vessels.
• Preserved left ventricular function and minimal myocardial injury despite the anomaly.

Conclusions:

• This case demonstrates an atypical presentation of ALCAPA with a milder clinical course.
• Extensive collateralization may play a crucial role in maintaining myocardial perfusion and function.
• Highlights the importance of considering varied presentations of ALCAPA in pediatric cardiology.