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Definition

Anomalous left coronary artery (ALCA) is a rare heart defect.

Normally, the left coronary artery carries oxygenated blood to the heart muscle. The oxygenated blood comes from the aorta.

With ALCA, the left coronary artery is not connected to the aorta. Instead, it is connected to the pulmonary artery. This means that the blood does not have enough oxygen in it from the lungs. With this defect, the heart muscles receive blood that is low in oxygen. The blood also leaks back into the pulmonary artery because of the low pressure in this artery.

The Coronary Arteries
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ALCA may be detected in newborns. In some cases, it may not be detected until the baby is aged 2-6 months. Rarely, it is diagnosed in older children.

Causes

ALCA is a congenital defect. This means that the baby is born with it. It is not known exactly why some babies’ left coronary artery develops abnormally.

Risk Factors

Risk factors are not known.

Symptoms

Symptoms may include:

  • Lower heart function
  • Rapid breathing
  • Poor feeding
  • Slow growth
  • Sweating
  • Irritability
  • Swelling around eyes and/or feet

Your child’s doctor may also detect a heart murmur during a physical exam.

This condition can lead to heart failure . If your child has any of these symptoms, get medical care right away.

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:

  • Echocardiogram —an imaging test that uses sound waves to look at the size, shape, and motion of the heart
  • Chest x-ray —an imaging test that uses low amounts of radiation to create an image of the chest
  • Electrocardiogram —a test that measures the electrical activity of the heart
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the chest
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
  • Cardiac catheterization —a test that uses a catheter (tube) and x-ray machine to assess the heart and its blood supply

Treatment

Talk with the doctor about the best treatment plan for your child. Treatment options include:

Surgery

Surgery is usually needed to correct this defect. During surgery, the left coronary artery is:

  • Detached from the pulmonary artery
  • Reconnected to the aorta

Lifelong Monitoring

Your child will need to have regular exams from a heart specialist. If your child has symptoms after surgery, the doctor may recommend:

  • Medicines
  • Lifestyle changes

Prevention

There is no known way to prevent anomalous left coronary artery. Getting proper prenatal care is always important.

Revision Information

  • American Family Physician

    http://www.aafp.org/

  • American Heart Association

    http://www.americanheart.org/

  • Canadian Cardiovascular Society

    http://www.ccs.ca/

  • Heart and Stroke Foundation of Canada

    http://ww2.heartandstroke.ca/splash/

  • Cove Point Foundation. Anomalous left coronary artery. Cove Point Foundation, Johns Hopkins University website. Available at: http://www.pted.org/?id=anomalouscoronary1 . Accessed July 12, 2010.

  • Mayo Clinic. Atrioventricular canal defect. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/atrioventricular-canal-defect/DS00745/DSECTION=risk-factors . Accessed July 7, 2010.

  • University of Michigan, CS Mott Children’s Hospital. Congenital heart defects: anomalous left coronary artery. University of Michigan, CS Mott Children’s Hospital website. Available at: http://www.med.umich.edu/mott/chc/patient%5Fcon%5Falca.html . Updated January 2010. Accessed July 12, 2010.