Anomalous origin of the left coronary artery from the pulmonary artery: A rare congenital cardiac anomaly masquerading as dilated cardiomyopathy

Abstract

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a cardiac anomaly which is quite complex and very rarely diagnosed. It can, however, have serious consequences for the patient. It has been divided into two types based on the age of presentation: the infant type and the adult type with different presentations and prognoses. The infant type usually presents with congestive heart failure or sometimes as myocardial infarction. Many of these patients do not make it beyond 1st year of life. The rare adult variant of ALCAPA syndrome may manifest as recurrent chest infections in the pediatric age group, dyspnea on exertion, or sometimes, even as sudden cardiac death. We report the case of a 7-year-old girl who presented with recurrent chest infections and echocardiography (ECG) was suggestive of dilated cardiomyopathy. The definitive diagnosis of ALCAPA was reached only by ECG-gated cardiac computed tomography.