ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually manifests as severe left-sided heart failure and mitral valve insufficiency during the first one to two months of life. The majority of these cases die in infancy if not correcte...

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Main Authors: Yan Liu, Beth W. Miller
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2012/471759
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author Yan Liu
Beth W. Miller
author_facet Yan Liu
Beth W. Miller
author_sort Yan Liu
collection DOAJ
description Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually manifests as severe left-sided heart failure and mitral valve insufficiency during the first one to two months of life. The majority of these cases die in infancy if not corrected early upon presentation. Adulthood presentation is rare and most of the untreated patients who reach adulthood present with left ventricular dysfunction, severe mitral regurgitation, and sometimes myocardial infarction. Here we report a case of a 20-year-old woman with a history of exercise intolerance since childhood that was misinterpreted as asthma until a 2D-Echo revealed ALCAPA with RCA collaterals to the left anterior descending artery, preserved LV ejection fraction, and absence of apparent mitral valve abnormality. One month after the ALCAPA diagnosis, she successfully underwent surgical reconstruction of left main and pulmonary artery without any major complications. She had normal left ventricular function without apparent ischemic cardiac symptoms eighteen months after procedure.
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series Case Reports in Cardiology
spelling doaj-art-35d4fbf04a19430cbcba3298451017ae2025-08-20T03:55:08ZengWileyCase Reports in Cardiology2090-64042090-64122012-01-01201210.1155/2012/471759471759ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac FunctionYan Liu0Beth W. Miller1Department of Internal Medicine, University of Texas Southwestern Medical School Residency Programs at Austin, University Medical Center Brackenridge, 601 E 15th Street, Austin, TX 78701, USADepartment of Internal Medicine, University of Texas Southwestern Medical School Residency Programs at Austin, University Medical Center Brackenridge, 601 E 15th Street, Austin, TX 78701, USAAnomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually manifests as severe left-sided heart failure and mitral valve insufficiency during the first one to two months of life. The majority of these cases die in infancy if not corrected early upon presentation. Adulthood presentation is rare and most of the untreated patients who reach adulthood present with left ventricular dysfunction, severe mitral regurgitation, and sometimes myocardial infarction. Here we report a case of a 20-year-old woman with a history of exercise intolerance since childhood that was misinterpreted as asthma until a 2D-Echo revealed ALCAPA with RCA collaterals to the left anterior descending artery, preserved LV ejection fraction, and absence of apparent mitral valve abnormality. One month after the ALCAPA diagnosis, she successfully underwent surgical reconstruction of left main and pulmonary artery without any major complications. She had normal left ventricular function without apparent ischemic cardiac symptoms eighteen months after procedure.http://dx.doi.org/10.1155/2012/471759
spellingShingle Yan Liu
Beth W. Miller
ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function
Case Reports in Cardiology
title ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function
title_full ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function
title_fullStr ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function
title_full_unstemmed ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function
title_short ALCAPA Presents in an Adult with Exercise Intolerance but Preserved Cardiac Function
title_sort alcapa presents in an adult with exercise intolerance but preserved cardiac function
url http://dx.doi.org/10.1155/2012/471759
work_keys_str_mv AT yanliu alcapapresentsinanadultwithexerciseintolerancebutpreservedcardiacfunction
AT bethwmiller alcapapresentsinanadultwithexerciseintolerancebutpreservedcardiacfunction