Diagnosis of adult ALCAPA with computed tomography coronary artery

Abstract Background Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly where the left main coronary artery arises from the pulmonary artery, instead of the coronary sinus of the ascending aorta. ALCAPA is divided into infant and adult types. Life-threateni...

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Auteurs principaux:	Yew Eng Tan, Kok King Chia, Noor Khairiah Abdul Karim
Format:	article
Langue:	EN
Publié:	SpringerOpen 2021
Sujets:	Congenital anomaly Adult onset ALCAPA Computed tomography coronary angiography Medical physics. Medical radiology. Nuclear medicine R895-920
Accès en ligne:	https://doaj.org/article/fbf0fc248d0a4e3f8de1afe07c902bfd
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spelling	oai:doaj.org-article:fbf0fc248d0a4e3f8de1afe07c902bfd2021-12-05T12:17:26ZDiagnosis of adult ALCAPA with computed tomography coronary artery10.1186/s43055-021-00667-y2090-4762https://doaj.org/article/fbf0fc248d0a4e3f8de1afe07c902bfd2021-11-01T00:00:00Zhttps://doi.org/10.1186/s43055-021-00667-yhttps://doaj.org/toc/2090-4762Abstract Background Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly where the left main coronary artery arises from the pulmonary artery, instead of the coronary sinus of the ascending aorta. ALCAPA is divided into infant and adult types. Life-threatening complications such as malignant arrhythmia and sudden death could ensue in adult type of ALCAPA. Imaging is the current preferred modality for ALCAPA. It is indeed a challenge to diagnose ALCAPA due to its non-specific clinical presentation and laboratory findings. We report a case of adult type ALCAPA presented with unstable angina surprisingly surviving into adulthood with no symptoms prior to presentation, which is extremely rare. Case presentation A 53-year-old lady presented with sudden onset of chest pain and worsening shortness of breath. She was initially treated as unstable angina. Physical examination revealed normal heart sound. Computed tomography coronary angiography (CTCA) showed an anomalous origin of the left coronary artery from the posterior wall of the proximal pulmonary artery, compatible with ALCAPA. The anomalous left coronary artery bifurcates into left anterior descending and left circumflex arteries. Cardiothoracic surgeon planned for occlusion of ALCAPA via the pulmonary artery, owing to the fact that unfeasible rerouting in the presence of well-established collateral supply. Conclusions ALCAPA is a rare and life-threatening condition in adults which may lead to myocardial infarction and sudden death in untreated cases. CTCA is one of the preferred modern imaging modality in ALCAPA owing to its superior ability for direct visualization of the anomaly. Hence, early identification and surgical intervention of the anomaly are paramount to reduce the morbidity and mortality.Yew Eng TanKok King ChiaNoor Khairiah Abdul KarimSpringerOpenarticleCongenital anomalyAdult onset ALCAPAComputed tomography coronary angiographyMedical physics. Medical radiology. Nuclear medicineR895-920ENThe Egyptian Journal of Radiology and Nuclear Medicine, Vol 52, Iss 1, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Congenital anomaly Adult onset ALCAPA Computed tomography coronary angiography Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	Congenital anomaly Adult onset ALCAPA Computed tomography coronary angiography Medical physics. Medical radiology. Nuclear medicine R895-920 Yew Eng Tan Kok King Chia Noor Khairiah Abdul Karim Diagnosis of adult ALCAPA with computed tomography coronary artery
description	Abstract Background Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly where the left main coronary artery arises from the pulmonary artery, instead of the coronary sinus of the ascending aorta. ALCAPA is divided into infant and adult types. Life-threatening complications such as malignant arrhythmia and sudden death could ensue in adult type of ALCAPA. Imaging is the current preferred modality for ALCAPA. It is indeed a challenge to diagnose ALCAPA due to its non-specific clinical presentation and laboratory findings. We report a case of adult type ALCAPA presented with unstable angina surprisingly surviving into adulthood with no symptoms prior to presentation, which is extremely rare. Case presentation A 53-year-old lady presented with sudden onset of chest pain and worsening shortness of breath. She was initially treated as unstable angina. Physical examination revealed normal heart sound. Computed tomography coronary angiography (CTCA) showed an anomalous origin of the left coronary artery from the posterior wall of the proximal pulmonary artery, compatible with ALCAPA. The anomalous left coronary artery bifurcates into left anterior descending and left circumflex arteries. Cardiothoracic surgeon planned for occlusion of ALCAPA via the pulmonary artery, owing to the fact that unfeasible rerouting in the presence of well-established collateral supply. Conclusions ALCAPA is a rare and life-threatening condition in adults which may lead to myocardial infarction and sudden death in untreated cases. CTCA is one of the preferred modern imaging modality in ALCAPA owing to its superior ability for direct visualization of the anomaly. Hence, early identification and surgical intervention of the anomaly are paramount to reduce the morbidity and mortality.
format	article
author	Yew Eng Tan Kok King Chia Noor Khairiah Abdul Karim
author_facet	Yew Eng Tan Kok King Chia Noor Khairiah Abdul Karim
author_sort	Yew Eng Tan
title	Diagnosis of adult ALCAPA with computed tomography coronary artery
title_short	Diagnosis of adult ALCAPA with computed tomography coronary artery
title_full	Diagnosis of adult ALCAPA with computed tomography coronary artery
title_fullStr	Diagnosis of adult ALCAPA with computed tomography coronary artery
title_full_unstemmed	Diagnosis of adult ALCAPA with computed tomography coronary artery
title_sort	diagnosis of adult alcapa with computed tomography coronary artery
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/fbf0fc248d0a4e3f8de1afe07c902bfd
work_keys_str_mv	AT yewengtan diagnosisofadultalcapawithcomputedtomographycoronaryartery AT kokkingchia diagnosisofadultalcapawithcomputedtomographycoronaryartery AT noorkhairiahabdulkarim diagnosisofadultalcapawithcomputedtomographycoronaryartery
_version_	1718372112293429248

Diagnosis of adult ALCAPA with computed tomography coronary artery

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