Cardiac Arrest During Exercise: Anomalous Left Coronary Artery from the Pulmonary Trunk

Abstract

Anomalous origin of the left coronary artery from the pulmonary trunk is associated with high mortality in infancy but in rare cases the condition is diagnosed in adults. The present report describes three adult cases of this anomaly. Two of the patients (age 18 and 34 years) were resuscitated from cardiac arrest, which had occurred in relation to physical exercise. The third patient (20 years) had presented with angina pectoris and signs of ischaemia on exercise ECG. In all patients, coronary arteriography revealed a large right coronary artery with collateral filling of the left coronary artery, which originated from the pulmonary trunk. A successful surgical correction of the anomalous coronary artery was performed in two of the patients.

Incidental Discovery of Anomalous Left Coronary Artery Arising from The Pulmonary Artery in a Coronavirus Disease-2019 Patient: A Blessing in Disguise

“…Owing to sufficient blood supply through collaterals from RCA to LCA however, some of the patient survive to adulthood. These patients are either asymptomatic, as in our case, or present with signs and symptoms of myocardial ischemia, left ventricular dysfunction, mitral regurgitation, malignant arrhythmias or sudden cardiac death [3][4][5].…”

Anomalous Origin of Left Coronary Artery from The Pulmonary Artery of Left Main Coronary Artery (ALCAPA) In A Pediatric Patient: A Rare Case Report

“…But, this additional heart sound may due to other associate pathology such as mitral regurgitation or dysfunction of other leaflet. 9 This case, the patient was found to be in a stable condition with minimal symptoms and a grade III/VI parasternal systolic murmur was obtained. In addition, ALCAPA may associate with others syndrome such as Scimitar syndrome, Berry syndrome, and Bland-White-Garland syndrome.…”

“…Symptoms range from fatigue, dyspnea, malignant ventricular arrhythmias resulting from myocardial scarring or chest pain, and exercise intolerance to sudden cardiac death due to acute ischemia during exercise. , 9,10 Here we report childhood onset anomaly of left coronary artery origin from the left main coronary artery pulmonary artery presenting with mild symptoms.…”

“…Deep Q waves in V5/V6 and ST depressions in the lateral leads found in ALCAPA with mitral regurgitation and ventricular dilatation. 9,7 On echocardiography, the infantile type often has left ventricular enlargement, reduced left ventricular systolic function, and moderate to large mitral valve. 1 Other possible finding were apical ventricular aneurysm, moderate to severe myocardium infarction (MI), dilated right coronary artery (RCA), coronary artery collateral circulation, and unable showing clear origin of LCA.…”

Anomalous origin of left coronary artery from pulmonary artery: A rare cause of myocardial infarction in children

“…[4] ALCAPA syndrome rarely manifests in teenagers and adults and may be an important cause of sudden cardiac arrest. [56] This review describes a rare but potentially lethal congenital heart disease.…”