Document Detail

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting as a complete heart block.
MedLine Citation:
PMID:  20165845     Owner:  NLM     Status:  MEDLINE    
A 51-year-old previously asymptomatic man presented with complete heart block (CHB). During pacemaker implantation, fluoroscopy showed a peculiar pattern of cardiac calcification. Coronary angiography, performed to determine the origin of calcification, demonstrated an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). A left ventriculogram showed normal ventricular contraction. Echocardiography demonstrated normal systolic function without any regional wall motion abnormality. The endocardium of the mid and basal portions of the anteroseptal, anterior and anterolateral walls as well as both of the papillary muscles were calcified. Specifically noted was a calcific bar extending across the base of the interventricular septum (IVS) on both the echocardiogram and the left ventricle angiogram. The development of CHB in the absence of transmural myocardial infarction is intriguing. It is likely that endocardial fibroelastosis during infancy led to endocardial fibrosis and scarring subsequent calcium deposition. Extension of this calcification into the conduction system may have led to CHB. This is the first report of an adult patient with ALCAPA presenting with CHB.
Ravi S Math; Neeraj Parakh; Simarjot S Sarin; Sanjay Tyagi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-02-18
Journal Detail:
Title:  Pediatric cardiology     Volume:  31     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-23     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  526-9     Citation Subset:  IM    
Department of Cardiology, GB Pant Hospital and Maulana Azad Medical College, Suite 127, First Floor, Academic Building, New Delhi 110002, India.
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MeSH Terms
Calcinosis / complications,  diagnosis*
Cardiomyopathies / complications,  diagnosis*
Coronary Angiography
Coronary Vessel Anomalies / diagnosis*
Endocardial Fibroelastosis / complications,  diagnosis
Heart Block / diagnosis,  etiology*,  therapy
Heart Septum
Middle Aged
Pacemaker, Artificial
Papillary Muscles
Pulmonary Artery / abnormalities*
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