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Year : 2019  |  Volume : 20  |  Issue : 3  |  Page : 126-127  

Anomalous left coronary artery from pulmonary artery

1 Department of Cardiology, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Cardiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India

Date of Web Publication26-Sep-2019

Correspondence Address:
Dr. Gopal Chandra Ghosh
Room No. 310, Hospital Annexe, Christian Medical College and Hospital Campus, Ida Scudder Road, Vellore - 632 004, Tamil Nadu
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Ghosh GC, Jose J, Gururani K. Anomalous left coronary artery from pulmonary artery. Heart Views 2019;20:126-7

How to cite this URL:
Ghosh GC, Jose J, Gururani K. Anomalous left coronary artery from pulmonary artery. Heart Views [serial online] 2019 [cited 2022 Aug 8];20:126-7. Available from: https://www.heartviews.org/text.asp?2019/20/3/126/267841

A 24-year-old homemaker presented with exertional angina of Canadian Cardiovascular Society Class I for 6 months. Her childhood was uneventful and clinical examination was unremarkable. Echocardiography revealed normal left ventricular function, absent left coronary artery (LCA) origin from aortic sinus, and a normal origin of a dilated right coronary artery (RCA) with torrential flow [Figure 1] and [Video 1]a. Significant collateral flow was noted in the interventricular septum [Video 1]b. Coronary angiography confirmed the absence of the LCA origin from aortic sinus [Figure 2]a and [Video 2]a and dilated collaterals in the interventricular septum are retrogradely supplying the LCA from the RCA [Video 2]b, which is draining into the main pulmonary artery [Figure 2]b and [Video 2]c.
Figure 1: Parasternal long axis view showing dilated right coronary artery

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Figure 2: (a) Aortic root angiogram, left anterior oblique view showing absent left coronary artery origin from aortic sinus. (b) Selective right coronary angiogram, right anterior oblique view showing retrograde filling of left coronary artery from the right coronary artery through dilated septal collaterals

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Eighty-five percentage of anomalous LCA from the pulmonary artery (ALCAPA) patients become symptomatic in their first two months of life. In adult age, ALCAPA can present with heart failure, mitral regurgitation, arrhythmic episodes, and also with angina or sudden cardiac death.[1] Our case highlights that ALCAPA can be considered as a differential diagnosis of angina with preserved ventricular function in a young lady. Echocardiography with intent to look for coronary origins will help in early diagnosis.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Kristensen T, Kofoed KF, Helqvist S, Helvind M, Søndergaard L. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: A case report. J Cardiothorac Surg 2008;3:33.  Back to cited text no. 1


  [Figure 1], [Figure 2]


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