Constante Andreia D, Loureiro Petra, Martins José F, Pinto Fátima
Pediatric Cardiology Department, Unidade Local de Saúde São José, Hospital de Santa Marta, Lisbon, PRT.
Cureus. 2024 Jul 10;16(7):e64294. doi: 10.7759/cureus.64294. eCollection 2024 Jul.
Coronary anomalies are one of the most surprising yet challenging pediatric cardiology diagnoses. The anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is frequently underdiagnosed due to a lack of typical signs or symptoms. We present a case of ARCAPA in a healthy six-month-old girl during follow-up of a newly detected heart murmur. Echocardiography raised the suspicion of a coronary anomaly, but the diagnosis was unclear, so cardiac catheterization and computed tomography were performed, which posteriorly confirmed the diagnosis. The patient underwent surgical repair, and the short-term follow-up has been uneventful. Regular monitoring is essential due to the potential long-term complications of ARCAPA, including myocardial ischemia, heart failure, and sudden cardiac death, underscoring the importance of early diagnosis and continuous management.
冠状动脉异常是儿科心脏病学中最令人惊讶但又具有挑战性的诊断之一。由于缺乏典型的体征或症状，右冠状动脉起源于肺动脉（ARCAPA）常常被漏诊。我们报告了一例在新发现心脏杂音随访期间，一名健康6个月大女童发生ARCAPA的病例。超声心动图引起了对冠状动脉异常的怀疑，但诊断尚不明确，因此进行了心导管检查和计算机断层扫描，随后确诊。患者接受了手术修复，短期随访情况良好。由于ARCAPA存在潜在的长期并发症，包括心肌缺血、心力衰竭和心源性猝死，定期监测至关重要，这凸显了早期诊断和持续管理的重要性。
