Anomalous left coronary artery from the main pulmonary trunk: physiologic and clinical importance of its association with persistent ductus arteriosus.
Anomalous left coronary artery (ALCA) from the pulmonary trunk presents in early infancy with a clinical picture of failure to thrive, congestive heart failure (CHF), angina-like episodes, and mitral insufficiency. These manifestations which are due to myocardial ischemia may change in the presence of an associated lesion. We present a case and review two previous reports of a patent ductus arteriosus (PDA) associated with this anomaly. Although signs and symptoms are not as clear due to the less impaired coronary perfusion and the presence of a PDA, the presence of mitral insufficiency should raise the possibility of an anomalous coronary artery and, therefore, a cardiac catheterization and angiocardiography are recommended in anticipation of reparative surgery.
Nehgme
R A
RA
Division of Pediatric Cardiology and Cardiovascular Surgery, Yale University School of Medicine, New Haven, Connecticut.
Dewar
M L
ML
Lutin
W A
WA
Talner
N S
NS
Hellenbrand
W E
WE
D001027:Aortography; D006328:Cardiac Catheterization; D003330:Coronary Vessel Anomalies / Q000503:physiopathology* / Q000601:surgery; D004374:Ductus Arteriosus, Patent / Q000503:physiopathology* / Q000601:surgery; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000503:physiopathology; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery