title: Anomalous origin of left coronary artery from pulmonary artery associated with pulmonary hypertension.
abstract: 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.
authors: Tenured Full-Time Associate Professor of Pediatric Interventional Cardiology, Deputy for Educational Affairs of the Department of Pediatrics, Children's Medical Center (Pediatrics Center of Excellence), No. 62, Dr. Gharib's Street, End of Keshavarz Boulevard, Tehran 1419733151, Iran. Electronic address: erad@tums.ac.ir.
authors: Elaheh
authors: E
authors: Malakan Rad
keywords: ALCAPA; Posterior pulmonary cusp view; Severe pulmonary hypertension
references: Images Paediatr Cardiol. 2010 Jul;12(3):3-8
references: 22368564
references: Pediatr Cardiol. 2011 Jan;32(1):24-31
references: 20976445
references: Am J Respir Crit Care Med. 2013 Jun 15;187(12):1394-5
references: 23767909
references: Indian Heart J. 2009 May-Jun;61(3):303-5
references: 20503844
references: J Am Soc Echocardiogr. 2012 Oct;25(10):1050-7
references: 22883316
references: Echocardiography. 2013 Aug;30(7):829-36
references: 23347291
references: J Clin Imaging Sci. 2013 Jan 30;3:4
references: 23607073
references: Congenit Heart Dis. 2014 Jul-Aug;9(4):E110-2
references: 23701826
references: J Am Soc Echocardiogr. 2011 Jun;24(6):625-36
references: 21392941
references: J Cardiothorac Surg. 2008;3:33
references: 18503713
references: J Am Soc Echocardiogr. 2009 Mar;22(3):242-50
references: 19168325
references: J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D34-41
references: 24355639
references: Eur J Echocardiogr. 2009 Jul;10(5):732-5
references: 19578125
references: Pediatr Cardiol. 2014 Jun;35(5):778-84
references: 24337706