Journal article
Myocardial Infarction and Complete Heart Block in a Patient With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery (ALCAPA)
Curēus (Palo Alto, CA), v 16(6), 62016
09 Jun 2024
PMID: 38984014
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation. We present a case of an elderly patient with ALCAPA presenting with complete heart block and non -ST -elevation myocardial infarction years after diagnosis and surgical correction. An 81 -year -old female with a history of ALCAPA presented to the emergency department with chest pain and progressive mental deterioration. She was bradycardic and hypotensive. An electrocardiogram revealed a complete heart block. Troponin was 4.04 ng/mL. She received atropine and underwent transcutaneous pacing. Left heart catheterization revealed complete occlusion of the mid-left circumflex artery, which was intervened with balloon angioplasty and chronic total occlusion of the right coronary artery. She was supported with temporary transvenous pacing, did not require further pacing support, and was discharged home. Previous records unearthed that in 1988 she had presented with syncope and was diagnosed with ALCAPA, filling from right-to-left collaterals with large and ectatic coronaries. At the time, she underwent surgical correction with excision of the left coronary from the pulmonary artery and reimplantation in the left coronary cusp along the posterior aorta. She had remained asymptomatic after her surgery until this presentation. ALCAPA is extremely rare in adults. Insufficient collaterals to the left ventricle cause inadequate blood supply, leading to ischemia in adults, predisposing them to arrhythmias and risk of sudden death. Adults with ALCAPA remain at increased risk of adverse cardiac events later in life, requiring longterm monitoring.
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Details
- Title
- Myocardial Infarction and Complete Heart Block in a Patient With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery (ALCAPA)
- Creators
- Muhammad Umer Riaz Gondal (Corresponding Author) - Reading HospitalDevi Parvathy Jyothi Ramachandran Nair - Reading HospitalSmit Shah - Reading HospitalMuhammad Zafar - Reading HospitalMuhammad Asad Hanif - Reading HospitalBrian McCauley - Reading HospitalEarl Hope - Reading Hospital
- Publication Details
- Curēus (Palo Alto, CA), v 16(6), 62016
- Publisher
- Springer Nature
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:001258894400001
- Other Identifier
- 991022193870004721
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InCites Highlights
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- Web of Science research areas
- Cardiac & Cardiovascular Systems