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Anomalous Left Coronary Artery from the Pulmonary Artery—Child(ALCAPA—Child)
Definition

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare heart defect.

Normally, the left coronary artery carries oxygenated blood to the heart muscle. The oxygenated blood comes from the aorta.

With ALCAPA, the left coronary artery is not connected to the aorta. Instead, it is connected to the pulmonary artery. This means that the blood does not have enough oxygen in it from the lungs. With this defect, the heart muscles receive blood that is low in oxygen. The blood also leaks back into the pulmonary artery because of the low pressure in this artery.

The Coronary Arteries

si1902_the coronary arteries

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ALCAPA may be detected in newborns. In some cases, it may not be detected until the baby is aged 2-6 months. Rarely, it is diagnosed in older children.

Causes

ALCAPA is a congenital defect. This means that the baby is born with it. It is not known why the left coronary artery develops abnormally.

Risk Factors

Risk factors for ALCAPA are not known.

Symptoms

Symptoms may include:

  • Rapid breathing
  • Poor feeding
  • Slow growth
  • Sweating
  • Irritability
  • Swelling around the eyes and/or feet

This condition can lead to heart failure . If your child has any of these symptoms, get emergency medical care right away.

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done.

Images may be taken of your child's bodily structures. This can be done with:

Your child's heart function may be tested. This can be done with:

Treatment

Talk with the doctor about the best treatment plan for your child. Treatment options include:

Surgery

Surgery is usually needed to correct this defect. During surgery, the left coronary artery is:

  • Detached from the pulmonary artery
  • Reconnected to the aorta
Lifelong Monitoring

Your child will need to have regular exams from a heart specialist. If your child has symptoms after surgery, the doctor may advise:

  • Medications
  • Lifestyle changes
Prevention

There is no known way to prevent ALCAPA. Getting proper prenatal care is always important.

RESOURCES:

American Heart Association
http://www.heart.org

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca

References:

ALCAPA. Congenital Heart Defects UK website. Available at: http://www.chd-uk.co.uk/types-of-chd-and-operations/alcapa/. Accessed May 29, 2014.

Anomalous left coronary artery. Cove Point Foundation, Johns Hopkins University website. Available at: http://www.pted.org/?id=anomalouscoronary1. Updated May 16, 2011. Accessed May 29, 2014.

Anomalous left coronary artery from the pulmonary artery (ALCAPA). Boston Children's Hospital website. Available at: http://www.childrenshospital.org/health-topics/conditions/anomalous-left-coronary-artery-from-the-pulmonary-artery-alcapa. Accessed May 29, 2014.

Anomalous left coronary artery from the pulmonary artery (ALCAPA). The Children's Hospital of Philadelphia website. Available at: http://www.chop.edu/service/cardiac-center/heart-conditions/anomalous-left-coronary-artery-from-pulmonary-artery.html. Updated June 2013. Accessed May 29, 2014.



Last reviewed May 2014 by Kari Kassir, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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