Anomalous left coronary artery

Jurishica, August J.

doi:10.1016/0002-8703(57)90130-8

Cited by 39 publications

(7 citation statements)

References 8 publications

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“…It has been suggested that the risk of sudden cardiac death with ALCAPA decreases with age [11]. Autopsy studies identifying adult cases with untreated ALCAPA showed an average age at death of 35 years [9,[18][19]. Formation of scarred tissue due to myocardial ischemia and new ischemic episodes could trigger life threatening arrhythmias and death [1].…”

Section: Discussionmentioning

confidence: 99%

Anomalous left coronary artery from the pulmonary artery (ALCAPA) diagnosed in adulthood: Varied clinical presentation, therapeutic approach and outcome

Boutsikou

Shore

et al. 2018

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Anomalous left coronary artery from the pulmonary artery (ALCAPA) diagnosed in adulthood: Varied clinical presentation, therapeutic approach and outcome

Boutsikou

Shore

et al. 2018

International Journal of Cardiology

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“…In a series of 11 cases of adult-type ALCAPA, Jurishica demonstrated a high incidence of sudden death at a young age. 8 Only 18% experienced symptoms prior to sudden death, suggesting that aggressive surgical management was appropriate for all adult patients. Nevertheless, early surgical treatment of ALCAPA enjoyed limited success.…”

Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in Adults: A Comprehensive Review of 151 Adult Cases and A New Diagnosis in a 53‐Year‐Old Woman

Yau

Singh²,

Halpern

et al. 2011

Clinical Cardiology

201

210

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Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and adult sudden death. As it predominantly presents in the first year of life, diagnosis in living adults is extremely rare. Current management is based on limited case series or extrapolated from pediatric cases. Modern advances in noninvasive cardiac imaging have substantially increased the number of diagnoses, uncovering a large adult population that has not been reviewed. Hypothesis: The availability of newer diagnostic modalities correlates with an increasing incidence in an older cohort, and true association between sudden death and ALCAPA may be lower, especially among older patients. Methods: A comprehensive literature search was performed for all case reports of ALCAPA on MEDLINE and PubMed using the keywords ALCAPA, Bland-White-Garland, and coronary anomaly; and augmented by references from published case reports from 1908 to 2008. All adult cases, defined by age 18 years and older, were reviewed for this article. Results: One hundred fifty-one adult cases of ALCAPA are described, in addition to the case of an asymptomatic 53-year-old woman. The average reported age was 41 years old with the oldest being 83. Sixty-six percent of the patients presented with symptoms of angina, dyspnea, palpitations, or fatigue; 17% presented with ventricular arrhythmia, syncope, or sudden death; and 14% were asymptomatic. Twelve percent were diagnosed at autopsy. The majority had some form of surgical correction during their clinical course. Conclusions: ALCAPA is a rare and life-threatening condition in adults. The availability of newer, less invasive diagnostic modalities has resulted in more frequent identification of this condition in an older cohort.

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“…Since adequate left coronary artery perfusion pressure exceeds that normally present in the pulmonary artery, the anastomotic circulation must be sufficient to supply a large enough flow of blood from the left coronary artery into the pulmonary artery to maintain a significant pressure gradient between the peripheral components of the left coronary artery vascular bed and the pulmonary artery. That blood flow is from the anomalous left coronary artery into the pulmonary artery in long-term survivors is supported by evidence cited by Edwards (1958), Jurishica (1957), George and Knowlan (1959), and Lampe and Verheugt (1960), and most recently in 2 of the 3 cases reported by Agustsson et al (1962). The surviving adults have usually not had a known history of illness in infancy, although the reliability of the evidence may be questioned.…”

Section: Discussionmentioning

confidence: 90%

Anomalous Left Coronary Artery Arising From Pulmonary Artery

Ag¹,

Ellis²,

Or³

1963

Heart

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Origin of the left coronary artery from the pulmonary artery is an uncommon congenital cardiac anomaly. Brooks (1886) first suggested that blood flow in this condition was from the coronary artery into the pulmonary artery. Nevertheless, the view that blood flow is in the opposite direction, i.e. from the pulmonary artery to the coronary artery, was commonly held until recently. Edwards (1958) and others (Abbott, 1927;Agustsson et al., 1962;Baffes, Ketola, and Tatooles, 1961;Case et al., 1958;Lampe and Verheugt, 1960;Sabiston, Neill, and Taussig, 1960) have recently presented evidence supporting Brooks' suggestion.We are presenting an angiocardiographic and catheter demonstration of flow from an anomalous left coronary artery into the pulmonary artery in a 4-year-old girl. CASE REPORTThe patient, born in this hospital in 1956, by breech delivery after a normal pregnancy, weighed 2740 g. At the time of her birth, her mother was 32 years old and well, and her father was 38. There were three normal siblings and there had been one miscarriage. At birth, she suffered from asphyxia neonatorum and had a weak cry: oxygen and resuscitative measures were required. The patient developed normally but was noted to be a poor feeder from birth. At the age of 4 months, two weeks before her first admission, she began to wheeze and cough and these symptoms persisted to the time of admission.On admission, the heart was found to be enlarged to the left with the apical impulse in the 5th to 6th left intercostal space in the anterior-axillary line. A rough, grade III, systolic murmur was heard over the the entire prmcordium: it was loudest at the apex and was transmitted to the axilla. P2 was louder than A2. Coarse breath sounds and some scattered wheezes were heard bilaterally.Chest X-ray examination demonstrated a very large heart. Areas of pneumonia were present in both lung apices and the left lower lobe was atelectatic (Fig. IA).A cardiogram showed normal sinus rhythm, a mean electrical QRS axis of +300, inverted T waves in leads I, II, aVL, aVF and over the left prwcordium, a prominent R wave in the left prncordial leads, and a deep S in VI. The tracing was consistent with severe left ventricular enlargement.The patient was considered to have congenital heart disease complicated by congestive heart failure and pneumonia. The diagnostic considerations included fibro-elastosis, idiopathic myocarditis, anomalous coronary artery, and glycogen storage disease. There was some immediate improvement with achromycin, penicillin, and digitalis, but after two days of therapy, the infant appeared to be in extremis. Chloramphenicol, ACTH, and cortisone were added to try to reverse the apparent rapid deterioration, and there was great improvement: the steroids were discontinued at the end of a week. A chest radiogram taken just before discharge showed clearing of the lungs but no significant change in the heart size or contour.There were two more admissions during her first year because of failure to thrive and a respiratory infection whi...

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Anomalous left coronary artery

Cited by 39 publications

References 8 publications

Anomalous left coronary artery from the pulmonary artery (ALCAPA) diagnosed in adulthood: Varied clinical presentation, therapeutic approach and outcome

Anomalous left coronary artery from the pulmonary artery (ALCAPA) diagnosed in adulthood: Varied clinical presentation, therapeutic approach and outcome

Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in Adults: A Comprehensive Review of 151 Adult Cases and A New Diagnosis in a 53‐Year‐Old Woman

Anomalous Left Coronary Artery Arising From Pulmonary Artery

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