Anomalous origin of single coronary artery trunk from the pulmonary artery.
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ABSTRACT:
SUBMITTER: Yue C
PROVIDER: S-EPMC8728731 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This is a report on a 10-year-old child with anomalous origin of left coronary artery (LCA) from pulmonary artery (ALCAPA), severe pulmonary hypertension (PH), old myocardial infarction and poor intercoronary collateralization. It discusses the echocardiographic pitfalls in this particular setting and introduces a new echocardiographic view (posterior pulmonary cusp view) for visualization of the anomalous origin of LCA from the posterior pulmonary cusp (PC) in patients with ALCAPA from the PC of the pulmonary artery. We describe three echocardiographic pitfalls that can mislead the echocardiographer and two helpful hints that guide the clinician to the correct diagnosis. The survival of this child shows that limited size of left ventricular myocardial infarction and severe mitral regurgitation in early infancy can result in a life-saving pulmonary hypertension which preserves viability and function of left ventricle despite lack of intercoronary collateral arteries. After one year follow-up, she is doing well on medical treatment.
| S-EPMC4310958 | biostudies-literature
Project description:Anomalous origin of the coronary artery from the pulmonary artery is a rare type of congenital heart disease (CHD). According to the establishment of collateral circulation and the abnormal anatomy of coronary arteries, there are several clinical types. In some clinical types, serious cardiac insufficiency can arise in the early stage of the condition, which, if not promptly treated, can endanger the patient's life. Up to 90% of infants with an anomaly involving the left coronary artery die within the first year of life. The treatment of the disease is to restore the double coronary circulation as soon as possible by surgery after early detection by diagnostic imaging. Presently, medical imaging is the most commonly used examination method for a diagnosis of the disease. The comprehensive application of various imaging modalities is the basis for the diagnosis and follow-up of coronary artery origin from the pulmonary artery. The current review mainly summarized the common signs and application advantages of different imaging techniques in the diagnosis of anomalous origin of the coronary artery from the pulmonary artery. It also highlights existing problems and provides an important theoretical basis and practical guidance for imaging techniques about the coronary artery originating from the pulmonary artery's diagnosis and treatment.
| S-EPMC9929387 | biostudies-literature
Project description: Not available
| S-EPMC6791095 | biostudies-literature
Project description:BackgroundAnomalous origin of a coronary artery from the pulmonary trunk is a small group of rare congenital anomalies present in up to 1% of the population. These patients, in absence of an adequate collateral supply, may present with congestive heart failure secondary to ischaemia, arrhythmia, or sudden cardiac death in up to 90% of cases within the first months of life.Case summaryWe present four cases diagnosed in adulthood over 10 years in two high-volume centres. The first patient presented with dyspnoea and orthopnoea. The second with chest pain and episodes of non-sustained ventricular tachycardia. The third patient presented during her third pregnancy with chest pain, palpitations, and arrhythmia (non-sustained ventricular tachycardia). The fourth patient presented with sudden cardiac death.DiscussionIn all cases with anomalous origin of coronary arteries, it is recommendable to consider surgical correction to avoid the progression of ischaemia, congestive heart failure, arrhythmia, and sudden death.
| S-EPMC7534175 | biostudies-literature
Project description: Not available
| S-EPMC9722405 | biostudies-literature
Project description:Isolated anomalous origin of right coronary artery is a rare developmental anomaly which is mostly asymptomatic and is discovered incidentally. We present a case of a 21-year-old male who presented with chest pain and was found to have anomalous origin of right coronary artery from pulmonary artery for which he underwent prompt surgical correction.
| S-EPMC6265226 | biostudies-literature
Project description:BackgroundAnomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. The enlarged right coronary artery provides retrograde collaterals to supply the left ventricle then preferentially directs into the lower pressure pulmonary artery system causing coronary steal phenomenon. Few patients who survive through adulthood without surgery must have abundant, well-formed functioning collaterals with adequate perfusion of the left ventricle. We present the oldest reported patient with ALCAPA to undergo corrective surgery.Case presentationA 79-year-old woman presented with a 3-months history of worsening shortness of breath and orthopnea. Physical examination discovered a soft continuous murmur at the left upper chest. Transthoracic echocardiography demonstrated an unusual, tubular-like structure inside the interventricular septum with a turbulent flow from color Doppler. Moreover, there was a severe mitral regurgitation from posterior mitral leaflet restriction associated with ventricular remodeling in combination with mitral annular dilatation. Coronary angiography and coronary computed tomography angiography established the diagnostic hallmark of ALCAPA syndrome. Stress cardiovascular magnetic resonance perfusion imaging demonstrated no myocardial ischemia suggesting adequate collateral circulation. Remarkably, there was a left coronary ostial stenosis, which served as a protective mechanism against myocardia ischemia by limiting the steal effect. The patient successfully underwent the ligation of anomalous artery at its origin in combination with bioprosthetic mitral valve replacement. Her postoperative course was uneventful.ConclusionsThis case utilized multimodality imaging for delineating the course of abnormal vessels and helping to formulate therapeutic decision.
| S-EPMC6006666 | biostudies-literature
Project description: Not available
| S-EPMC7494704 | biostudies-literature
Project description: Not available
| S-EPMC5658291 | biostudies-literature
Project description:BackgroundAn anomalous origin of the right coronary artery from pulmonary artery (ARCAPA) is a very rare coronary anomaly.Case summaryA 56-year-old man, presenting haemodynamically unstable due to very rapid atrial fibrillation, was found to have ARCAPA by coronary computed tomography angiography. He had normal left ventricular ejection fraction and without reversible ischaemia on an adenosine stress rubidium positron emission tomography. He was treated solely with betablockers and has been well since.DiscussionNumerous case reports on ARCAPA have previously been published, but no previous reports have found rapid atrial fibrillation to be the primary symptom of presentation. Current evidence level concerning the treatment is low; nevertheless, surgical intervention should always be considered to prevent sudden cardiac death. The patient in this case was offered surgical intervention but declined.
| S-EPMC10019809 | biostudies-literature