Adult ALCAPA Presenting with Apical Left Ventricular Aneurysm and Ventricular Arrhythmia
Fushun Liao1, Huan Lu1, Haili Sun1
1Department of Ultrasound Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
Insights
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect. This case highlights adult presentation due to collateral circulation, emphasizing the need for advanced imaging and timely surgical repair.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Medical Imaging
Background:
- Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac anomaly.
- Most infants present with severe symptoms, requiring early intervention.
- A subset of patients may develop collateral circulation, masking ischemia and allowing adult presentation.
Abstract:
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac anomaly. Most affected infants develop significant symptoms shortly after birth and require early intervention to improve survival. However, a small subset of patients develops extensive collateral circulation, which may mask myocardial ischemia and, in very rare cases, allow them to reach adulthood without obvious cardiac symptoms. We report such a case in which a patient presented with mild chest discomfort during a routine examination at our hospital. Multimodality imaging, including echocardiography and contrast-enhanced computed tomography (CT), three-dimensional CT reconstruction, confirmed the diagnosis of ALCAPA syndrome. The patient subsequently underwent Takeuchi repair, preventing future adverse cardiovascular events or chronic left ventricular dysfunction.
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