Background: Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a very uncommon congenital coronary artery anomaly, most commonly presenting in early infancy. Late adult presentation of ALCAPA syndrome is extremely rare.
Case Summary: We present a case of a 76-year-old patient with first presentation of ALCAPA. The coronary anomaly was first diagnosed during elective coronary angiography. The case was discussed at the Heart Team meeting and as the patient was asymptomatic, had good coronary collateral circulation, a medical treatment strategy was chosen and the patient was discharged in a good physical condition. During 3 years of follow-up, the patient has experienced no cardiovascular complications.
Discussion: We hereby also discuss briefly the clinical presentation, epidemiology, diagnostics and treatment options for adults with newly diagnosed ALCAPA and discuss the need for a new clinical classification. Only a few cases have been published of septuagenarians or octogenarians with first presentation of ALCAPA. To our knowledge, the patient presented in our case was one of the least symptomatic patients during her eight decades of life.
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http://dx.doi.org/10.1093/ehjcr/ytaa318 | DOI Listing |
Indian J Thorac Cardiovasc Surg
February 2025
Ankara City Hospital Cardiovascular Surgery, Ankara, Turkey.
Unlabelled: The Bland-White-Garland syndrome, or Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) syndrome, is a rare congenital cardiac anomaly often associated with high mortality, if left untreated. We present a case of a 43-year-old female with undiagnosed ALCAPA who initially underwent mitral valve surgery for severe mitral regurgitation, only to require reoperation due to adult-type ALCAPA. Intraoperatively, the discovery of dilated right coronary artery and its branches and absence of the left coronary ostium prompted further investigation, leading to the diagnosis of adult-type ALCAPA.
View Article and Find Full Text PDFPediatr Cardiol
January 2025
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (DHM), Technische Universität München (TUM), Lazarettstr. 36, 80636, Munich, Germany.
Anomalous origin of coronary arteries from the pulmonary artery (ACAPA) are rare but clinically significant condition with high mortality if left untreated. Even more rarely, ACAPA is associated with other congenital heart defects. From 1974 to 2024, 120 patients with anomalous coronary arteries connected to the pulmonary artery were retrospectively analyzed.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Cardiology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.
A man in his early 50s presented to the emergency department (ED) with sudden onset of palpitation and presyncope. The 12-lead electrocardiogram (ECG) recorded in ED showed monomorphic ventricular tachycardia requiring cardioversion in view of haemodynamic instability. The patient was subsequently detected to have an anomalous left coronary artery origin from the pulmonary artery.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Cardiology Department, Meir Medical Center, Tchernichovsky St 59, Kfar Saba 4418001, Israel.
Background: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA) (ALCAPA) is a rare congenital abnormality. We present a case of an ALCAPA in a 25-year-old man.
Case Summary: A 25-year-old male with no past medical history was admitted to our intensive cardiac care unit after sudden cardiac arrest due to ventricular fibrillation and suspected acute coronary syndrome.
Ann Pediatr Cardiol
November 2024
Department of Pediatric Cardiology, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India.
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease, presenting either in isolation or with other cardiac anomalies. The most common presentation is congestive heart failure in infancy, though some may remain asymptomatic till adulthood. A 5-month-old infant with congestive heart failure was diagnosed to have ALCAPA with severe Left ventricular (LV) dysfunction.
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