Echocardiographic Diagnosis, Surgical Treatment, and Outcomes of Anomalous Left Coronary Artery from the Pulmonary Artery

Asymptomatic young man with an incidental murmur

“…Noteworthy there is subtle thickening of the chorda of the papillary muscles suggestive of fibrotic change reported in ALCAPA (figure 1A). 2 The CTA confirmed the diagnosis. Figure 1D,E shows the origin of the left coronary artery (LCA) from the pulmonary artery and a tortuous huge RCA, respectively.…”

“…ALCAPA, occurring in approximately 1/300 000 live births, is usually diagnosed in the first year of life and presents with congestive heart failure resulting from inadequate blood supply to the myocardium, and is associated with 90% mortality if left untreated 1. In the presence of sufficient collaterals, the affected infant may grow out of the condition 2. Angina, palpitations, syncope and sudden death have been reported as the presenting symptoms in adults.…”

The role of echocardiography in anomalous origin of coronary artery from pulmonary artery (ALCAPA): Simple tool for a complex diagnosis

“…5 However, there are still some concerns that further confirmatory diagnostic evaluations may be beneficial especially since coronary anomalies are reported to be among the most common congenital anomalies misdiagnosed by echocardiography. 5 However, there are still some concerns that further confirmatory diagnostic evaluations may be beneficial especially since coronary anomalies are reported to be among the most common congenital anomalies misdiagnosed by echocardiography.…”

“…In Petal et al's series, echocardiography was the only diagnostic test performed in 50% of the ALCAPA patients who underwent surgery. 5 However, there are still some concerns that further confirmatory diagnostic evaluations may be beneficial especially since coronary anomalies are reported to be among the most common congenital anomalies misdiagnosed by echocardiography. 6 In addition to presenting our cases, we have emphasized on their distinctive echocardiographic features while reviewing previous reports.…”

Recommendations for Multimodality Assessment of Congenital Coronary Anomalies: A Guide from the American Society of Echocardiography

“…This is the least commonly identified finding, however, because dropout of the tissue separating the CA from the aorta can give the false impression of a normal LCA origin. 70 Identification of retrograde filling of the LCA using color Doppler is an essential echocardiographic component of the diagnosis of ALCAPA ( Figure 13B). Color flow in the normally originating LCA progresses away from the aortic root (red Doppler signal in parasternal short-axis view).…”