Sudden Cardiac Arrest in an Adult with Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA): Case Report

Francesca Romana Prandi, Ali N. Zaidi, Gina LaRocca, Michael Hadley, Maria Riasat, Malcolm O. Anastasius, Pedro R. Moreno, Samin Sharma, Annapoorna Kini, Raghav Murthy, Percy Boateng and Stamatios Lerakis
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Francesca Romana Prandi: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Ali N. Zaidi: Mount Sinai Adult Congenital Heart Disease, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Gina LaRocca: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Michael Hadley: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Maria Riasat: Division of Internal Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY 10003, USA
Malcolm O. Anastasius: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Pedro R. Moreno: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Samin Sharma: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Annapoorna Kini: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Raghav Murthy: Division of Cardiothoracic Surgery, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Percy Boateng: Division of Cardiothoracic Surgery, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Stamatios Lerakis: Division of Cardiology, Mount Sinai Heart, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA

IJERPH, 2022, vol. 19, issue 3, 1-10

Abstract: Introduction: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare coronary artery anomaly that carries 90% mortality in the first year of life when left untreated. The diagnosis of ALCAPA is rare in adulthood, and it includes a broad spectrum of clinical manifestations, including sudden cardiac death (SCD). Case report: We report a rare case of resuscitated sudden cardiac arrest in a 55-year-old female, who was diagnosed with ALCAPA and underwent successful surgical correction and implantable cardioverter defibrillator (ICD) implantation for secondary prevention. Discussion: ALCAPA diagnosis is not confined to childhood, and it represents a rare cause of life-threatening arrhythmias and SCD in the adult population. Surgical correction is recommended, regardless of age, presence of symptoms or inducible myocardial ischemia. Multimodality imaging is crucial for diagnosis, management planning and follow up. Assessment of the risk of recurrent ventricular arrhythmias, despite full revascularization, should be performed in all adults with ALCAPA. Myocardial scar detected via late gadolinium enhancement represents a potential irreversible substrate for ventricular arrhythmias, and it provides additional information to evaluate indication of an ICD for secondary prevention.

Keywords: anomalous origin of coronary artery from pulmonary artery; ALCAPA; cardiac arrest; implantable cardioverter defibrillator; sudden cardiac death; multimodality cardiac imaging (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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