title: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report.
abstract: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. The usual clinical course is severe left sided heart failure and mitral valve insufficiency presenting during the first months of life. However, in some cases collateral blood supply from the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion. Coronary angiography and CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images before and after surgery.
authors.affiliation: Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Denmark. tskaarup@yahoo.com
authors.forename: Thomas
authors.initials: T
authors.lastname: Kristensen
authors.forename: Klaus Fuglsang
authors.initials: KF
authors.lastname: Kofoed
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
authors.forename: Morten
authors.initials: M
authors.lastname: Helvind
authors.forename: Lars
authors.initials: L
authors.lastname: Søndergaard
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004554:Electric Countershock / Q000295:instrumentation; D005260:Female; D006801:Humans; D011651:Pulmonary Artery / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy