ALCAPA

Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) is a rare congenital heart defect. This condition is also known by its more descriptive name, anomalous origin of the left coronary artery from the pulmonary artery. In individuals with ALCAPA, the left coronary artery, which normally arises from the aorta, originates from the pulmonary artery instead. This anomaly significantly impacts the heart's function and is a serious condition that requires prompt medical attention.

Overview

In a healthy heart, the coronary arteries originate from the aorta and supply the heart muscle with oxygen-rich blood. In ALCAPA, the left coronary artery's abnormal connection to the pulmonary artery leads to a reduced oxygen supply to the heart muscle. This is because the pulmonary artery carries oxygen-poor blood, which is not suitable for the nourishment of heart muscle tissues. Over time, this can lead to myocardial ischemia, infarction, and, if left untreated, heart failure.

Symptoms

Symptoms of ALCAPA may vary depending on the age of onset and the severity of the condition. In infants, common symptoms include rapid breathing, sweating, and feeding difficulties. Older children and adults might experience chest pain, fainting, or symptoms of heart failure like shortness of breath and fatigue.

Diagnosis

Diagnosis of ALCAPA involves a combination of clinical evaluation and imaging studies. Echocardiography is commonly used to visualize the anomalous coronary artery. Cardiac MRI and CT angiography can also provide detailed images of the heart's structure and blood flow, aiding in the diagnosis.

Treatment

The treatment for ALCAPA is surgical correction to re-establish normal coronary artery anatomy. The most common surgical approach is the reimplantation of the left coronary artery into the aorta. Other surgical techniques, such as the creation of a tunnel between the aorta and the left coronary artery or the use of a graft, may be considered based on the individual case.

Prognosis

The prognosis for individuals with ALCAPA significantly improves with early diagnosis and surgical treatment. Most patients who undergo surgery in infancy or early childhood can expect to lead normal lives, although they may require lifelong cardiac monitoring.

Epidemiology

ALCAPA is a rare condition, affecting approximately 1 in 300,000 live births. It accounts for less than 0.5% of all congenital heart defects.

See Also

• Congenital heart defect
• Coronary artery
• Pulmonary artery
• Heart failure

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