scholarly journals The role of multimodal imaging in the diagnosis of an asymptomatic patient with congenital anomaly

2020 ◽  
Author(s):  
Raluca Tomoaia ◽  
Adrian Molnar ◽  
Ruxandra Ștefana Beyer ◽  
Alexandra Dădârlat-Pop ◽  
Florina Frîngu ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Multimodal Imaging ◽  
Left Coronary Artery ◽  
Asymptomatic Patient ◽  
Coronary Anomaly ◽  
Anomalous Left Coronary Artery ◽  
Inducible Ischemia ◽  
Anomalous Left Coronary ◽  
Congenital Coronary Anomaly

Anomalous left coronary artery from the pulmonary artery (ALCAPA) syndrome is a rare congenital coronary anomaly, which can cause potentially fatal complications, such as heart failure, myocardial infarction and sudden cardiac death. Only a few patients left untreated survive to adulthood. We highlight the importance of multimodal imaging in the diagnosis of ALCAPA syndrome in a young asymptomatic female patient with inducible ischemia on exercise. The patient was successfully treated with surgery

scholarly journals Anomalous Left Coronary Artery from the Pulmonary Artery: The Role of Multimodal Imaging—A Case Report

2020 ◽  
Vol 10 (2) ◽  
pp. 25-32
Author(s):  
Mita Singh ◽  
Ana Teresa Gomes ◽  
Moad El-Haddad ◽  
Abdel Khalid Saidmeerasah ◽  
Rashid Iqbal
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Multimodal Imaging ◽  
Left Coronary Artery ◽  
Surgical Intervention ◽  
Collateral Flow ◽  
Anomalous Left Coronary Artery ◽  
Anomalous Left Coronary

Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) is a rare coronary artery anomaly which accounts for 0.25–0.5% of all congenital cardiac diseases, where most die within the first year of life. We present a case report of a 50-year-old lady who presented to hospital with persistent palpitations. Her admission electrocardiogram found her to be in Atrial Fibrillation (AF). She was rate-controlled and subsequently discharged. Despite that, she represented with further episodes of AF and was referred for an outpatient transthoracic echocardiogram. This revealed a dilated right coronary artery, retrograde flow in the left coronary artery and collateral flow in the myocardium. To investigate, the patient had undergone further imaging which confirmed the diagnosis. As such, she was later shortlisted for surgical intervention. Conclusively, our case exemplifies the role of multimodal imaging to identify the features of ALCAPA and may be useful for the purposes of surgical intervention.

Unusual sudden cardiac death from an anomalous left coronary artery from the right sinus of Valsalva

2013 ◽  
Vol 24 (4) ◽  
pp. 732-734 ◽  
Author(s):  
Ram N. Bishnoi ◽  
Kristen N. McMillan ◽  
William R. Thompson
Keyword(s):  
Coronary Artery ◽  
Left Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Anomaly ◽  
Sinus Of Valsalva ◽  
Anomalous Left Coronary Artery ◽  
Congenital Cardiac Defects ◽  
The Right ◽  
Anomalous Left Coronary ◽  
Congenital Coronary Anomaly

AbstractA left coronary artery arising from the right sinus of Valsalva is a rare congenital coronary anomaly. We report a case of a 5-year-old boy with an anomalous left coronary artery from the right sinus of Valsalva whose presenting sign was cardiac arrest. There is no reported instance of a child <9 years of age without other congenital cardiac defects having died suddenly with this coronary anomaly. The transthoracic echocardiogram demonstrated normal origins of the coronary arteries, but on autopsy, an anomalous origin of the left main coronary artery from the right sinus of Valsalva was found.

Reimplantation of an anomalous left coronary artery with a malignant course

2018 ◽  
Vol 26 (6) ◽  
pp. 473-475 ◽  
Author(s):  
Yutaka Imoto ◽  
Tomoyuki Matsuba ◽  
Hideaki Kanda ◽  
Yuki Ogata ◽  
Shuji Nagatomi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiac Death ◽  
Left Coronary Artery ◽  
Main Pulmonary Artery ◽  
Ascending Aorta ◽  
Coronary Ostium ◽  
Anomalous Left Coronary Artery ◽  
Single Coronary Ostium ◽  
Anomalous Left Coronary ◽  
Aortic Cuff

A 14-year-old boy was diagnosed with an anomalous left coronary artery coursing between the ascending aorta and the main pulmonary artery and associated with a single coronary ostium. Owing to the high risk of sudden cardiac death, surgery was performed although he was asymptomatic with no sign of myocardial ischemia. Reimplantation of an anomalous left coronary artery is generally considered difficult because an aortic cuff is unavailable for coronary anastomosis; however, we accomplished a successful direct reimplantation in this patient. This procedure offers another choice in the surgical treatment of anomalous left coronary artery.

scholarly journals Aborted Sudden Cardiac Death After Unroofing of Anomalous Left Coronary Artery

2017 ◽  
Vol 104 (3) ◽  
pp. e265-e267 ◽  
Author(s):  
Hitesh Agrawal ◽  
S. Kristen Sexson-Tejtel ◽  
Athar M. Qureshi ◽  
Mahboob Alam ◽  
Prakash Masand ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Left Coronary Artery ◽  
Anomalous Left Coronary Artery ◽  
Anomalous Left Coronary

Acquired and congenital coronary artery abnormalities

2017 ◽  
Vol 27 (S1) ◽  
pp. S31-S35 ◽  
Author(s):  
Ming-Lon Young ◽  
Michael McLeary ◽  
Kak-Chen Chan
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Cardiac Death ◽  
Left Coronary Artery ◽  
Sinus Of Valsalva ◽  
Anomalous Left Coronary Artery ◽  
Coronary Artery Abnormalities ◽  
Asymptomatic Patients ◽  
The Right ◽  
Anomalous Left Coronary

AbstractSudden unexpected cardiac deaths in approximately 20% of young athletes are due to acquired or congenital coronary artery abnormalities. Kawasaki disease is the leading cause for acquired coronary artery abnormalities, which can cause late coronary artery sequelae including aneurysms, stenosis, and thrombosis, leading to myocardial ischaemia and ventricular fibrillation. Patients with anomalous left coronary artery from the pulmonary artery can develop adequate collateral circulation from the right coronary artery in the newborn period, which remains asymptomatic only to manifest in adulthood with myocardial ischaemia, ventricular arrhythmias, and sudden death. Anomalous origin of coronary artery from the opposite sinus occurs in 0.7% of the young general population aged between 11 and 15 years. If the anomalous coronary artery courses between the pulmonary artery and the aorta, sudden cardiac death may occur during or shortly after vigorous exercise, especially in patients where the anomalous left coronary artery originates from the right sinus of Valsalva. Symptomatic patients with evidence of ischaemia should have surgical correction. No treatment is needed for asymptomatic patients with an anomalous right coronary artery from the left sinus of Valsalva. At present, there is no consensus regarding how to manage asymptomatic patients with anomalous left coronary artery from the right sinus of Valsalva and interarterial course. Myocardial bridging is commonly observed in cardiac catheterisation and it rarely causes exercise-induced coronary syndrome or cardiac death. In symptomatic patients, refractory or β-blocker treatment and surgical un-bridging may be considered.

A Rare Case of Anomalous Left Coronary Artery From the Pulmonary Artery (Bland-White-Garland Syndrome) in a 68-Year-Old Woman

2016 ◽  
Vol 21 (2) ◽  
pp. 186-190
Author(s):  
S. Michael Roberts ◽  
Trey Banbury ◽  
Anand Mehta
Keyword(s):  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Pulmonary Artery ◽  
Cardiac Death ◽  
Left Coronary Artery ◽  
Anesthetic Management ◽  
Anomalous Left Coronary Artery ◽  
Initial Symptoms ◽  
Intraoperative Management ◽  
Anomalous Left Coronary

Anomalous left coronary artery from the pulmonary artery (ALCAPA), or Bland-White-Garland syndrome, is a rare congenital coronary anomaly that results in altered myocardial perfusion and a left to right shunt. It occurs in 1:300000 live births and represents 0.24% to 0.46% of all congenital cardiac diseases. Despite its rarity, it is one of the most common causes of ischemia and infarction in children. Ninety percent of these patients will die within the first year of life if untreated and diagnosing this abnormality in adulthood is extremely rare. Of those patients who survive to adulthood, the average age of sudden cardiac death is 35 years. The initial symptoms of the adult presentation vary widely from progressive dyspnea to sudden cardiac death; therefore, immediate surgical correction is highly recommended upon diagnosis. Understanding the pathophysiology and nature of collateral coronary flow in this congenital anomaly is paramount to the safe anesthetic management of adults with ALCAPA. Here we describe the intraoperative management and echocardiographic findings in a 68-year-old with with recently diagnosed ALCAPA undergoing surgical repair.

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