Anomalous Left Coronary Artery from the Pulmonary Artery -- 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
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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.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 11/2014 -
  • Update Date: 05/29/2014 -
  • American Heart Association

    http://www.heart.org

  • Family Doctor—American Academy of Family Physicians

    http://www.familydoctor.org

  • Canadian Cardiovascular Society

    http://www.ccs.ca

  • Heart and Stroke Foundation of Canada

    http://www.heartandstroke.com

  • ALCAPA. Congenital Heart Defects UK website. Available at: http://www.chd-uk.co.uk/types-of-chd-and-operations/alcapa/. Accessed November 7, 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 November 7, 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 November 7, 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 November 7, 2014.