Anomalous origin of the left coronary artery from the pulmonary artery initially visualized by echocardiography and multidetector computed tomography coronary angiography.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly associated with very high mortality during infancy. We report a 35-year-old female patient with ALCAPA initially visualized by echocardiography. She visited outpatient department presenting with intermittent chest discomfort for 3 weeks. Transthoracic echocardiography showed left coronary artery arising from main pulmonary artery and abundant septal color flow Doppler signals. Transesophageal echocardiography clearly revealed markedly dilated and tortuous right coronary artery showing windsock appearance. Multidetector computed tomography and coronary angiography enabled visualization of anomalous left coronary artery originating from left side of main pulmonary trunk. After treadmill exercise test which showed ST-segment depression presenting inducible myocardial ischemia, patient underwent direct re-implantation of the anomalous coronary artery into the aorta without any complication.
Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea.
Byung-Ho
BH
Kim
Yon Woong
YW
Park
Seung-Pyo
SP
Hong
Ja-Yung
JY
Son
Young-Soo
YS
Lee
Jin-Bae
JB
Lee
Jae-Kean
JK
Ryu
Ji-Yong
JY
Choi
Kee-Sik
KS
Kim
Sung-Guk
SG
Chang
Computed tomography; Coronary vessel anomalies; Echocardiography