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ALCAPA - Anomalous Left Coronary Artery from the Pulmonary Artery

Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA), also known as Bland-White-Garland syndrome (BWG) is a heart defect. The left coronary artery, which carries blood to the heart muscle, is connected to the pulmonary artery instead of to the aorta.

A congenital coronary artery anomaly in which the left coronary artery arises from the pulmonary artery rather than its usual origin from the aorta. This condition is one cause of poor cardiac function in infancy.

In children with ALCAPA, the left coronary artery starts at the pulmonary artery. The pulmonary artery is the major blood vessel that takes oxygen-poor blood from the heart to the lungs.

An anomalous left coronary artery from the pulmonary artery is a problem that occurs when the baby's heart is developing early in the pregnancy. The developing blood vessels in the heart do not connect correctly.

It is often an isolated anomaly but can be associated with other cardiac anomalies in approximately 5% of cases, including :
  • Atrial septal defect (ASD)
  • Ventricular septal defect (VSD)
  • Coarctation of the aorta

Symptoms of ALCAPA in an infant include:
  • crying or sweating during feeding
  • pale skin
  • poor feeding
  • rapid breathing
Tests for anomalous left coronary artery include:
  • A test of the electrical activity in the heart (electrocardiogram)
  • A special dye injected into the blood vessels of the heart to see their structure and position (arteriography)
  • A thin tube (catheter) inserted in a blood vessel of the heart to measure blood pressure and oxygen levels (cardiac catheterization)
  • Cardiac magnetic resonance imaging (MRI)
  • Chest x-rays
  • Ultrasound of the heart (echocardiogram)

Source :

Pediatric Nurses