Kc Sharada, Karki Parag, Khatiwada Abhikanta, Pokhrel Saroj
Department of Internal Medicine, NAIHS.
Department of Radiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Ann Med Surg (Lond). 2024 Aug 8;86(9):5622-5626. doi: 10.1097/MS9.0000000000002451. eCollection 2024 Sep.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. While only a few of those born with this anomaly survive into adulthood, it becomes an extremely rare diagnosis in adults.
Here, the authors present a case of ALCAPA in a symptomatic adult female with angina and palpitations that was repeatedly missed on transthoracic echocardiogram.
The adult type of ALCAPA is often missed due to non-specific changes in electrocardiogram, leading to reluctance for angiography. Therefore, identifying abnormal coronaries in echocardiogram is crucial.
It is essential to consider anomalous coronary arteries as a differential diagnosis in patients with chest pain, despite their rarity. This case report highlights the role of various cardiac imaging modalities in improving the diagnostic yield of ALCAPA.
左冠状动脉起源于肺动脉（ALCAPA）是一种罕见的先天性异常。虽然患有这种异常的人中只有少数能存活到成年，但在成年人中这成为一种极其罕见的诊断。
在此，作者报告一例有症状的成年女性ALCAPA病例，该患者有胸痛和心悸症状，经胸超声心动图多次漏诊。
成人型ALCAPA常因心电图非特异性改变而漏诊，导致不愿进行血管造影。因此，在超声心动图中识别异常冠状动脉至关重要。
尽管冠状动脉异常罕见，但在胸痛患者中必须将其作为鉴别诊断考虑。本病例报告强调了各种心脏成像方式在提高ALCAPA诊断率方面的作用。
