Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report |
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Authors: | Thomas Kristensen Klaus Fuglsang Kofoed Steffen Helqvist Morten Helvind Lars Søndergaard |
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Institution: | (1) Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Denmark;(2) Department of Cardiology and Thoracic Surgery, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark |
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Abstract: | Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. The usual clinical
course is severe left sided heart failure and mitral valve insufficiency presenting during the first months of life. However,
in some cases collateral blood supply from the right coronary artery is sufficient and symptoms may be subtle or even absent.
Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report
a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion. Coronary angiography and
CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary
artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images
before and after surgery. |
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